Shared Flashcard Set

Details

101 mid term
101 mid term
210
Nursing
Undergraduate 1
08/02/2014

Additional Nursing Flashcards

 


 

Cards

Term

You are the charge nurse responsible for the eveningshift. During rounds, you hear the patient care techni-cian yelling loudly to a patient regarding his transferfrom the bed to chair. When entering the room, whichof the following is your best response?

a.“You need to speak to the patient quietly. You aredisturbing the patient.”

b.“Let me help you with your transfer technique.”

c.“When you are finished, be sure to apologize foryour rough demeanor.”

d.“When your patient is safe and comfortable, meetme at the desk.”

Definition
d.The charge nurse should direct the patient care tech-nician to determine the patient’s safety. Then she or heshould address any concerns regarding the patient caretechnician’s communication techniques privately. It isimportant that the nurse directs the patient care techni-cian on aspects of therapeutic communication.
Term

The public health nurse is leaving the home of a youngmother who has a special needs baby. The neighborstates, “How is she doing, since the baby’s father is nohelp?” What is the nurse’s best response to the neighbor?

a.“New mothers need support.”

b.“The lack of a father is difficult.”

c.“How are you today?”

d.“It is a very sad situation.”

Definition
a.It is important that the nurse maintain confidentialitywhen providing care. The statement of “New mothersneed support” is a general statement that all new parentsneed help. The statement is not judgmental of the fam-ily’s roles.
Term

A 3-year-old child is being admitted to the medical divi-sion for vomiting, diarrhea, and dehydration. During theadmission interview, the nurse should implement whichof the following communication techniques to elicit themost information from the parents?

a.The use of statements that indicate the patient willbe all right

b.The use of questions that contain the word how

c.The use of a leading question and those involving yes or no

d.The use of questions that direct comments to clarify

Definition
d.Direct comments that clarify will assist the nurse inobtaining adequate information.
Term

The nurse enters the patient’s room and examines thepatient’s IV fluids and cardiac monitor. The patientstates, “Well, I haven’t seen you before. Who are you?”Which of the following is the nurse’s best response?

a.“I’m just the IV therapist checking your IV.”

b.“I’ve been transferred to this division and will becaring for you.”

c.“I’m sorry, my name is John Smith. I’m responsiblefor your IV.”

d.“My name is John Smith. I’ll be caring for you until11 p.m.”

Definition
d.The nurse should identify himself, be sure the patientknows what will be happening, and the time period hewill be with his patient.
Term

The nurse enters the room of a patient with cancer. Heis crying and states, “I feel so alone.” Of the followingstatements, which is the most therapeutic?

a.The nurse stands at the patient’s bedside and states,“I understand how you feel. My mother said thesame thing when she was ill.”

b.The nurse places a hand on the patient’s arm andstates, “You feel so alone.”

c.The nurse stands in the patient’s room and asks,“Why do you feel so alone? Your wife has been here every day.”

d.The nurse holds the patient’s hand and asks, “Whatmakes you feel so alone?

Definition
d.The use of Therapeutic Touch conveys acceptance,and the implementation of an open-ended questionallows the patient time to verbalize freely.
Term

During discharge teaching, the nurse should:

a.Determine the progress made in established goals

b.Clarify when the patient should take medications

c.Report the progress made in teaching to the staff

d.Include all family members in the teaching session

Definition
a.The discharge planning phase coordinates with thetermination phase of a helping relationship. It is impor-tant that the nurse determine the progress made inachieving the goals related to the patient’s care.
Term

the nursing student is nervous and concerned about thework she is about to do at the clinical facility. To allayanxiety and be successful in her provision of care, it isimportant for her to:

a.Determine the established goals of the institution

b.Be sure her verbal and nonverbal communication iscongruent

c.Engage in self-talk to plan her day and decrease herfear

d.Speak with her fellow colleagues about how theyfeel

Definition
c.By engaging in self-talk, or intrapersonal communica-tion, the nursing student can plan her day and enhanceher clinical performance to decrease fear and anxiety.
Term

A nurse on the rehabilitation division states to her headnurse, “I need the day off and you didn’t give it to me!”The head nurse replies, “Well, I wasn’t aware youneeded the day off, and it isn’t possible since staffing is so inadequate.” In the act of sending the message,which statement would be considered more effective?

a.“Mr. Tyler, I placed a request to have August 8th off,but I’m working and I have a doctor’s appointment.”

b.“Mr. Tyler, I would like to discuss my schedule withyou. I requested the 8th of August off for a doctor’sappointment. Could I make an appointment?”

c.“Mr. Tyler, I will need to call in on the 8th of Augustbecause I have a doctor’s appointment.”

d.“Mr. Tyler, since you didn’t give me the 8th of Augustoff, will I need to find someone to work for me?”

Definition
b.Effective communication by the sender involves theimplementation of nonthreatening information byshowing respect to the receiver. The nurse should iden-tify the subject of the meeting and be sure it occurs at amutually agreed upon time.
Term

During a nursing staff meeting, the nurses determinethat they will make sure all vital signs are reported andcharted within 15 minutes following assessment. Thisis an example of:

a.Group Decision Making

b.Group Leadership

c.Group Identity

d.Group Patterns of Interaction

Definition
c.Ascertaining that the staff completes a task on timeand that all members agree the task is important is acharacteristic of group identity.
Term

A patient walking to the bathroom with a stooped gaitis noted with facial grimacing. It is important that thenurse assess the patient for which of the following?

a.Pain

b.Anxiety

c.Depression

d.Fluid Volume Deficit

Definition
a.A patient who presents with nonverbal communica-tion of a stooped gait and facial grimacing is mostlikely experiencing pain. It is important that the nurseclarify this nonverbal behavior.
Term

A nursing student is preparing to administer morningcare to the patient. What is the most important questionthat the nursing student should ask the patient?

a.“Would you prefer a bath or a shower?”

b.“May I help you with a bed bath now or later thismorning?”

c.“I will be giving you your bath. Do you use soap orshower gel?”

d.“I prefer a shower in the evening. When would youlike your bath?

Definition
b.It is important that the nurse asks permission to assistthe patient with a bath. This allows for consent to assist thepatient with care that invades the patient’s private zones.
Term

A nurse is providing instruction to the patient regardingthe procedure to change his colostomy bag. During theteaching session, he asks, “What type of foods should Iavoid to prevent gas?” The question the patient hasasked allows for which of the following?

a.A closed-ended answer

b.Information clarification

c.The nurse to give advice

d.A yes or no answer

Definition
b.The patient’s question allows the nurse to clarifyinformation that is new to the patient or that requiresfurther explanation.
Term

When interacting with a patient, the nurse answers, “I am sure everything will be fine. You have nothing to worry about.” This is an example of which of thefollowing inappropriate communication techniques?

a.Cliché

b.Giving advice

c.Being judgmental

d.Changing the subject

Definition
a.Telling a patient that everything is going to be all rightis a cliché. The use of this statement is giving false assur-ance. The use of clichés gives the patient the impressionthat the nurse is not interested in the patient’s condition.
Term

A 76-year-old patient states, “I have been experiencingcomplications of diabetes.” The nurse needs to directthe patient to gain more information. What is the mostappropriate comment or question to elicit additionalinformation?

a.“Do you take two injections of insulin to decreasethe complications?”

b.“Most physicians recommend diet and exercise toregulate blood sugar.”

c.“Most complications of diabetes are related to neu-ropathy.”

d.“What specific complications have you experienced?”

Definition
d.Requesting specific information regarding complica-tions of diabetes will elicit specific information to guidethe nurse in further interview questions and specificassessment techniques.
Term

During an interaction with a critically ill patient’s fam-ily, the nurse uses the communication technique ofsilence. This technique assists the family to:

a.Communicate with the patient

b.Plan for discharge

c.Organize their thoughts

d.Decrease anxiety

Definition
c.Silence allows the family to organize their thoughtsand develop any questions specific to understanding thepatient’s care
Term

A nurse assesses an oral temperature for a patient as38.5C (101.3F). What term would the nurse use toreport this temperature?

a.Fever

b.Hypothermia

c.Hypertension

d.Afebrile

Definition
a.Fever is an elevation of body temperature.
Term

A nurse is assessing vital signs on several hospitalizedchildren. The nurse would plan to use the oral route toassess temperature for which patient?

a.6-month-old infant

b.Patient receiving oxygen therapy by mask

c.15-year-old healthy adolescent

d.Unconscious patient

Definition
c.A healthy adolescent would be an appropriate patientfor assessing temperature by the oral route.
Term

When assessing a temperature rectally, the nurse woulduse extreme care when inserting the thermometer toprevent which of the following?

a.An increase in heart rate

b.A decrease in heart rate

c.A decrease in blood pressure

d.An increase in respirations

Definition
b.Insertion of a rectal thermometer may stimulate thevagus nerve, which, in turn, would decrease heart rate.This may potentially be harmful for patients with car-diac problems.
Term

While taking an adult patient’s pulse, a nurse finds therate to be 140 beats/min. What should the nurse do next?

a.Check the pulse again in 2 hours.

b.Check the blood pressure.

c.Record the information.

d.Report the rate.

Definition
d.A rate of 140 beats/min in an adult is an abnormalpulse and should be reported to the instructor or thenurse in charge of the patient.
Term

A patient complains of severe abdominal pain. Whenassessing the vital signs, the nurse would not besurprised to find what assessment?

a.An increase in the pulse rate

b.A decrease in body temperature

c.A decrease in blood pressure

d.An increase in respiratory depth

Definition
a.The pulse often increases when an individual isexperiencing pain. Pain does not affect body tempera-ture and may increase (not decrease) blood pressure.Acute pain may increase respiratory rate but decreaserespiratory depth.
Term

The nurse is taking an apical pulse. What equipmentwill he take into the patient’s room?

a.Sphygmomanometer

b.Electronic thermometer

c.Stethoscope

d.Doppler apparatus

Definition
c.The apical pulse can only be assessed by listeningwith a stethoscope.
Term

Two nurses are taking an apical-radial pulse and note a difference in pulse rate of 8 beats per minute. Thenurse would document this difference as which of thefollowing?

a.Pulse deficit

b.Pulse amplitude

c.Ventricular rhythm

d.Heart arrhythmia

Definition
a.The difference between the apical and radial pulserate is called the pulse deficit.
Term

Before assessing respirations, the nurse reviews normalrates for adults. Which rate would the nurse identify asnormal?

a.1 to 6 breaths/min

b.12 to 20 breaths/min

c.60 to 80 breaths/min

d.100 to 120 breaths/min

Definition
b.The normal respiratory rate for adults is 12 to 20 breaths/min.
Term

A patient is having dyspnea. What would the nurse dofirst?

a.Remove pillows from under the head

b.Elevate the head of the bed

c.Elevate the foot of the bed

d.Take the blood pressure

Definition
b.Elevating the head of the bed allows the abdominalorgans to descend, giving the diaphragm greater roomfor expansion and facilitating lung expansion
Term

A student nurse is learning to assess blood pressure.What does the blood pressure measure?

a.Flow of blood through the circulation

b.Force of blood against arterial walls

c.Force of blood against venous walls

d.Flow of blood through the heart

Definition
b.Blood pressure is the measurement of the force ofblood against arterial walls.
Term

A nurse knows that the blood pressure is often higherin older adults based on the understanding that whichof the following occurs with aging?

a.Loss of muscle mass

b.Changes in exercise level

c.Decreased peripheral resistance

d.Decreased elasticity in arterial walls

Definition
d.With aging, elasticity in arterial walls isdecreased, contributing to an elevated blood pressure reading.
Term

A patient has a blood pressure reading of 130/90 mm Hgwhen visiting a clinic. What would the nurserecommend to the patient?

a.Follow-up measurements of blood pressure

b.Immediate treatment by a physician

c.Nothing, because the nurse considers this reading isdue to anxiety

d.A change in dietary intake

Definition
a.A single blood pressure reading that is mildlyelevated is not significant, but the measurement shouldbe taken again over time to determine if hypertension isa problem. The nurse would recommend a return visitto the clinic for a recheck.
Term

A nurse is documenting a blood pressure of 120/80 mm Hg. The nurse interprets the 120 to represent which of the following?

a.Pulse rate

b.Diastolic pressure

c.Systolic pressure

d.Pulse deficit

Definition
c.The systolic pressure is 120 mm Hg. The diastolicpressure is 80 mm HG.
Term

It is important to have the appropriate cuff size whentaking the blood pressure. What error may result from a cuff that is too large or too small?

a.An incorrect reading

b.Injury to the patient

c.Prolonged pressure on the arm

d.Loss of Korotkoff sounds

Definition
a.A blood pressure cuff that is not the right size maycause an incorrect reading
Term

A patient has intravenous fluids infusing in the rightarm. When taking a blood pressure on this patient,what would the nurse do in this situation?

a.Take the blood pressure in the right arm

b.Take the blood pressure in the left arm

c.Use the smallest possible cuff

d.Report inability to take the blood pressure

Definition
b.The blood pressure should be taken in the arm oppo-site the one with the infusion.
Term

1.When assessing a patient’s eyes, which instrumentwould the nurse use to visualize the retina?

a.Otoscope

b.Ophthalmoscope

c. Stethoscope

d. Tuning fork

Definition
b.Only the ophthalmoscope is used to assess theinternal eye.
Term

Which of the following would be most important for anurse to do to ensure the accuracy of inspection duringassessment?

a. Compare bilateral body parts

b. Have 20/20 vision

c. Focus on selected body systems

d. Use touch judiciously

Definition
a.With inspection, a comparison of bilateral body partsis necessary for recognizing abnormal ndings. Perfectvision is unnecessary; the nurse examines all bodysystems and uses touch during palpation.
Term

When palpating body structures, the nurse uses whichsense?

a. Intuition

b. Vision

c. Hearing

d. Touch

Definition
d.Palpation is the technique that uses the sense of touch.
Term

Percussion over the stomach reveals a loud, drum-likesound. The nurse would document this nding aswhich of the following?

a. Dullness

b. Flatness

c.Tympany

d. Resonance

Definition
c.Tympany is a loud, drum-like sound, heard over anair-lled organ.
Term

While conducting a physical assessment, the nurseuses the bell of the stethoscope to hear which type ofsounds?

a. Tympanic sounds

b. Bowel sounds

c. Lung sounds

d. Heart sounds

Definition
d.The bell of the stethoscope is used to hear low-pitched sounds, such as those produced by the heartand vascular system.
Term

Which technique would a nurse use to assess skinturgor?

a. Indent area with fingertips

b. Use a special type of lighting

c. Touch the area to detect moisture

d. Lightly pinch a fold of skin

Definition
d.Skin turgor is assessed by lightly pinching a fold ofskin and allowing it to return to its shape when released.
Term

A patient’s visual acuity is assessed as 20/40 in botheyes using the Snellen chart. The nurse interprets thisnding as which of the following?

a. The patient can see twice as well as normal

b. The patient has double vision

c. The patient has less than normal vision

d. The patient has normal vision

Definition
c.Normal vision is 20/20. A finding of 20/40 wouldmean that a patient has less than normal vision.
Term

When using an otoscope to assess the tympanic mem-brane of an adult, the nurse straightens the ear canal by gently pulling the pinna in which direction?

a. Up and back

b. Down and forward

c. Away from the examiner

d. In any direction

Definition
a.The ear canal of an adult is straightened by gentlypulling the pinna of the ear up and back. In childrenyounger than 3 years of age, the ear canal is straightenedby pulling the pinna gently down and back.
Term

Which phrase best describes the science of nursing?

a.The skilled application of knowledge

b.The knowledge base for care

c.Hands-on care, such as giving a bath

d.Respect for each individual patient

Definition

b.The science of nursing is the knowledge base for carethat is provided. In contrast, the skilled application of thatknowledge is the art of nursing.

Term

Which nurse in history is credited with establishingnursing education?

a.Clara Barton

b.Lillian Wald

c.Lavinia Dock

d.Florence Nightingale

Definition
d.Florence Nightingale established nursing education.
Term

What historic event in the 20th century led to anincreased emphasis on nursing and broadened the role of nurses?a.Religious reform

b.Crimean War

c.World War II

d.Vietnam War

Definition
c.During World War II, large numbers of women workedoutside the home. There was an increased emphasis oneducation and a knowledge explosion in medicine andtechnology, broadening the roles of nurses.
Term

Which of the following phrases describes one of thepurposes of the ANA’s Nursing’s Social PolicyStatement?

a.To describe the nurse as a dependent caregiver

b.To provide standards for nursing educationalprograms

c.To regulate nursing research

d.To describe nursing’s values and social responsibility

Definition
d.The Nursing’s Social Policy Statement describes thevalues and social responsibility of nursing.
Term

5.A school nurse is teaching a class of junior-highstudents about the effects of smoking. This educationalprogram will meet which of the aims of nursing?

a.Promoting health

b.Preventing illness

c.Restoring

d.Facilitating coping with disability or death

Definition
b.Educational programs can reduce the risk of illnessby teaching good health habits.
Term

Which of the following nursing degrees prepares anurse for advanced practice as a clinical specialist ornurse practitioner?a.LPN

b.ADN

c.BSN

d.Master’s

Definition
d.A master’s degree prepares advanced practice nurses.
Term

Which nursing organization was the first internationalorganization of professional women?

a.ICN

b.ANA

c.NLN

d.NSNA

Definition
a.The ICN, founded in 1899, was the first internationalorganization of professional women.
Term

What is the purpose of the ANA’s Scope and Standardsof Practice?

a.To describe the ethical responsibility of nurses

b.To define the activities that are special and unique tonursing

c.To establish nursing as an independent and free-standing profession

d.To regulate the practice of nursing

Definition
b.The ANA’s Scope and Standards of Practice definethe activities of nurses that are specific and unique tonursing.
Term

What type of authority regulates the practice of nursing?a.International standards and codes

b.Federal guidelines and regulations

c.State nurse practice acts

d.Institutional policies

Definition
c.Nurse practice acts are established in each state toregulate the practice of nursing.
Term

Who are the largest group of healthcare providers inthe United States?

a.Registered nurses

b.Physicians

c.Physical therapists

d.Social workers

Definition
a.Registered nurses are the largest group of healthcareproviders in the United States.
Term

Which of the following phrases best defines culture?

a.A dominant group within a society

b.A shared system of beliefs, values, and behaviors

c.One’s values are replaced by the values of the domi-nant culture

d.Categories are based on specific physical character-istics

Definition
b.Culture may be defined as a shared system of beliefs,values, and behavioral expectations that provide socialstructure for daily living.
Term

Minority groups living within a dominant culture maylose the cultural characteristics that made them differ-ent. What is this process called?

a.Cultural diversity

b.Cultural imposition

c.Cultural assimilation

d.Ethnocentrism

Definition
c.When minority groups live within a dominant group,many members lose the cultural characteristics thatonce made them different.
Term

Which of the following terms is defined as the sense ofidentification with a collective cultural group?

a.Ethnicity

b.Race

c.Cultural acquisition

d.Culture shock

Definition
a.Ethnicity is the sense of identification with a collec-tive cultural group, largely based on the group’scommon heritage.
Term

A nurse states, “That woman is 78 years old—too oldto learn how to change a dressing.” What is the nursedemonstrating?

a.Cultural imposition

b.Clustering

c.Cultural competency

d.Stereotyping

Definition
d.Stereotyping is assuming that all members of agroup are alike.
Term

A young Hispanic mother comes to the local clinicbecause her baby is sick. She speaks only Spanishand the nurse speaks only English. What should thenurse do?

a.Use short words and talk more loudly

b.Ask an interpreter for help

c.Explain why care can’t be provided

d.Provide instructions in writing

Definition
b.Many agencies have a qualified interpreter whounderstands the healthcare system and can reliably provide assistance.
Term

A nurse is interviewing a newly admitted patient. Whichquestion would be considered culturally sensitive?

a.“Do you think you will be able to eat the food wehave here?”

b.“Do you understand that we can’t prepare specialmeals?”

c.“What types of food do you eat for meals?”

d.“Why can’t you just eat our food while you arehere?”

Definition
c.Asking patients what types of foods they eat formeals is culturally sensitive.
Term

7.What group is the largest subculture of the healthcaresystem?

a.Nurses

b.Physicians

c.Social workers

d.Physical therapists

Definition
a.Nurses are the largest subculture of the healthcaresystem.
Term

A nurse states, “I know I am cleaner than most of mypatients.” What does this statement indicate?

a.Cultural assimilation

b.Racism

c.Ethnocentrism

d.Stereotyping

Definition
c.Ethnocentrism occurs when one believes that one’sown ideas and practices are superior to those of others.
Term

A nurse wants to acquire knowledge of a specificculture. What could be done first?

a.Talk to coworkers

b.Review literature

c.Talk to family members of the patient

d.Ask others with more experience for help

Definition
b.Reviewing the literature about a specific culture canprovide the nurse with a starting point for informationabout cultural values, dietary practices, family lines ofauthority, and health and illness beliefs and practices.
Term

Although all of the following are important to culturallycompetent nursing care, which one is most basic?

a.Learning another language

b.Having significant information

c.Treating each person as an individual

d.Recognizing the importance of family

Definition
c.In all aspects of nursing, it is important to treat eachpatient as an individual. This is also true in providingculturally competent care.
Term

Of the following statements, which is most true ofhealth and illness?

a.Health and illness are the same for all people.

b.Health and illness are individually defined by eachperson.

c.People with acute illnesses are actually healthy.

d.People with chronic illnesses have poor healthbeliefs

Definition
b.Each person defines health and illness individually,based on a number of factors.
Term

A nurse has volunteered to give influenza injectionsat a local clinic. What level of care is he demonstrating?

a.Tertiary

b.Secondary

c.Primary

d.Promotive

Definition
c.Giving influenza injections is an example of primaryhealth promotion and illness prevention.
Term

A nurse’s neighbor tells her, “I have a hightemperature, feel awful, and I am not going to work.”What stage of illness behavior is the neighborexhibiting?

a.Experiencing symptoms

b.Assuming the sick role

c.Assuming a dependent role

d.Achieving recovery and rehabilitation

Definition
b.When people assume the sick role, they define them-selves as ill, seek validation of this experience fromothers, and give up normal activities.
Term

A nurse is caring for a patient with heart failure, achronic illness. Which of the following characteristicsis not a part of chronic illness?

a.Permanent change in body structure or function

b.Self-treatment that relieves symptoms

c.Long period of treatment and care

d.Often has remissions and exacerbations

Definition
b.Acute illnesses are often self-treated to relieve symp-toms.
Term

The agent–host–environment model of health andillness is based on what concept?

a.Risk factors

b.Infectious diseases

c.Behaviors to promote health

d.Stages of illness

Definition
a.The interaction of the agent–host–environment creates risk factors that increase the probability ofdisease.
Term

When providing health promotion classes, a nurse usesconcepts from models of health. What do both thehealth–illness continuum and the high-level wellnessmodels demonstrate?

a.Illness as a fixed point in time

b.The importance of family

c.Wellness as a passive state

d.Health as a constantly changing state

Definition
d.Both these models view health as a dynamic(constantly changing state).
Term

Following the birth of his first child and after readingabout the long-term effects of nicotine, John decides tostop smoking. This behavior change is most likelybased on John’s perceptions of all but one of thefollowing. Which one is nottrue?

a.His susceptibility to lung cancer

b.How serious lung cancer would be

c.What benefits his stopping smoking will have

d.Personal choice and economic factors

Definition
d.Responses a, b,and care components of the healthbelief model.
Term

Of the following clinic patients, which one is mostlikely to have annual breast examinations andmammograms based on the physical humandimension?

a.Jane, because her best friend had a benign breastlump removed

b.Sarah, who lives in a low-income neighborhood

c.Tricia, who has a family history of breast cancer

d.Nancy, because her family encourages regularphysical examinations

Definition
c.A family history of breast cancer is a major risk factor.
Term

A nurse is asked to teach a group of young adults ahealthy lifestyle. One young man says, “I stopped eat-ing fast foods to lose weight.” What model of health orillness explains this behavior?

a.Health–illness continuum

b.Agent–host–environment model

c.Health promotion model

d.Health belief model

Definition
c.The health promotion model illustrates how health-related behaviors and beliefs promote health.
Term

A nurse follows the guidelines for a healthy lifestyle.How can this promote health in others?

a.By being a role model for healthy behaviors

b.By not requiring sick days from work

c.By never exposing others to any type of illness

d.By spending less money on food

Definition
a.Good personal health enables the nurse to serve as arole model for patients and families.
Term

A nurse is providing care based on Maslow’s hierarchyof basic human needs. For which of the following nurs-ing activities is this approach useful?

a.Making accurate nursing diagnoses

b.Establishing priorities of care

c.Communicating concerns more concisely

d.Integrating science into nursing care

Definition
b.Maslow’s hierarchy of basic human needs is usefulfor establishing priorities of care.
Term

Which of the following levels of basic human needs ismost basic?

a.Physiologic

b.Safety and security

c.Love and belonging

d.Self-actualization

Definition
a.Physiologic needs are the most basic and must bemet at least minimally to sustain life.
Term

Of all the physiologic needs, which one is the mostessential?

a.Food

b.Water

c.Elimination

d.Oxygen

Definition
d.Oxygen is the most essential of all needs because allbody cells require oxygen for survival.
Term

Practicing careful hand hygiene and using sterile tech-niques are ways in which nurses meet which basichuman need?a.Physiologic

b.Safety and security

c.Self-esteem

d.Love and belonging

Definition
b.By carrying out careful hand hygiene and usingsterile technique, nurses provide safety from infection
Term

Of the following statements, which one is true of self-actualization?

a.Humans are born with fully developed self-actualization.

b.Self-actualization needs are met by havingconfidence and independence.

c.The self-actualization process continues throughoutlife.

d.Loneliness and isolation occur when self-actualizationneeds are unmet.

Definition
c.Self-actualization, or reaching one’s full potential, isa process that continues through life.
Term

What is the best broad definition of a family?

a.A father, a mother, and children

b.A group whose members are biologically related

c.A unit that includes aunts, uncles, and cousins

d.A group of people who live together

Definition
d.Although all the responses may be true, the bestdefinition is a group of people who live together.
Term

Where do individuals learn their health beliefs andvalues?

a.In the family

b.In school

c.From school nurses

d.From peers

Definition
a.Healthcare activities, health beliefs, and health valuesare learned within one’s family.
Term

John and Mary, each parents of one child, are bothdivorced. When they marry, the family structure that is formed will be described as which of thefollowing?

a.Nuclear family

b.Extended family

c.Blended family

d.Cohabiting family

Definition
c.A blended family is formed when parents bringunrelated children from previous relationshipstogetherto form a new family.
Term

Which of the following is one of the developmentaltasks of the older adult family?

a.Maintain a supportive home base

b.Prepare for retirement

c.Cope with loss of energy and privacy

d.Adjust to loss of spouse

Definition
d.A developmental task of the older adult family isadjusting to the loss of a spouse.
Term

Which of the following is one element of a healthycommunity?

a.Meets all the needs of its inhabitants

b.Offers access to healthcare services

c.Has mixed residential and industrial areas

d.Is little concerned with air and water quality

Definition
b.A healthy community offers access to healthcareservices to treat illness and to promote health.
Term

When you ask an older student why it is necessary tochange the patient’s bed every day, he says, “I guess wehave always done it that way.” This answer is an exam-ple of which of the following?

a.Unsubstantiated knowledge

b.Scientific knowledge

c.Authoritative knowledge

d.Traditional knowledge

Definition
d.Traditional knowledge is the part of nursing practicepassed down from generation to generation, often with-out research data to support it
Term

One method of developing a theory is by first examin-ing a general idea and then considering specific actionsor ideas. What is this method called?

a.Inductive reasoning

b.Deductive reasoning

c.Conceptual modeling

d.Concept development

Definition
b.Moving from a general idea to specific ideas isdeductive reasoning.
Term

When describing the term conceptto a group of students, which word would the instructor mostlikely use?

a.Fact

b.Science

c.Idea

d.Truth

Definition
c.A concept, like an idea, is an abstract impression ofreality.
Term

Which type of theory focuses on clinical nursingpractice?

a.Prescriptive theory

b.Descriptive theory

c.Developmental theory

d.Systems theory

Definition
a.Prescriptive theories address nursing interventionsand are designed to control, promote, and change clini-cal nursing practice.
Term

After reviewing information about the four conceptscommon to nursing theories, the students demonstrateunderstanding of the information when they identifywhich concept as most important?

a.Person

b.Environment

c.Health

d.Nursing

Definition
a.Of the four concepts, the most important is the person.
Term

When conducting research, information is collected.This would be identified as which of the following?

a.Subject

b.Analysis

c.Data

d.Abstract

Definition
c.Data are observable and verifiable informationcollected to describe, explain, or predict events.
Term

Which type of quantitative research is conducted todirectly influence or improve clinical practice?

a.Basic research

b.Applied research

c.Experimental research

d.Descriptive research

Definition
b.Applied research, a type of quantitative research, isdesigned to directly influence or improve clinicalpractice.
Term

A nurse researcher is studying the effects of exerciseand sleep on blood pressure. The researcher identifiesblood pressure as which type of variable?

a.Exploratory

b.Correlational

c.Dependent

d.Independent

Definition
c.The dependent variable is the variable being studiedand is determined by manipulating conditions (theindependent variables).
Term

Of the following types of qualitative research, whichmethod developed in anthropology?

a.Historical

b.Ethnography

c.Grounded theory

d.Phenomenology

Definition
b.Ethnographic research was developed by thediscipline of anthropology and is used to examineissues of culture of interest to nursing.
Term

A nurse is formulating a clinical question in PICOformat. Which of the following is represented by the letter P?

a.Comparison to another similar treatment

b.Clearly defined, focused literature review

c.Specific identification of the desired outcome

d.Explicit descriptions of population of interest

Definition
d.The P in the PICO format represents an explicitdescription of the patient population of interest.
Term

Five-year-old Bobby has dietary modifications relatedto his diabetes. His parents want him to value goodnutritional habits and they decide to deprive him of afavorite TV program when he becomes angry after theydeny him foods not on his diet. This is an example ofwhat mode of value transmission?

a.Modeling

b.Moralizing

c.Laissez-faire

d.Rewarding and punishing

e.Responsible choice

Definition
d.When rewarding and punishing are used to transmitvalues, children are rewarded for demonstrating valuesheld by parents and punished for demonstrating unac-ceptable values.
Term

Which of the following is the best professional responseto a patient who tells you that she believes that “whitenurses are smarter than nurses of color” and then asks ifyou agree?

a.“You are right!” (The patient/customer is alwaysright!)

b.“What I think doesn’t matter. What’s important iswhatever you believe.” (Value neutrality)

c.“I don’t believe being smart is related to race orethnicity.” (Commitment to human dignity)

Definition
c.While it is true that value neutrality commits nurses tocare for patients whether or not the nurse and patienthold the same value, it is not true that nurses should sac-rifice their moral integrity and compromise their beliefsor values to please a patient.
Term

The American Association of Colleges of Nursing iden-tified five values that epitomize the caring professionalnurse. Which of these is best described as acting inaccordance with an appropriate code of ethics andaccepted standards of practice?

a.Altruism

b.Autonomy

c.Human dignity

d.Integrity

e.Social justice

Definition
d.The American Association of Colleges of Nursingdefines integrity as acting in accordance with anappropriate code of ethics and accepted standards ofpractice.
Term

A professional nurse with a commitment to socialjustice is most apt to:

a.Provide honest information to patients and the public

b.Promote universal access to healthcare

c.Plan care in partnership with patients

d.Document care accurately and honestly

Definition
b.The American Association of Colleges of Nursinglists promoting universal access to healthcare as anexample of social justice. Providing honest informationand documenting care accurately and honestly areexamples of integrity, and planning care in partnershipwith patients is an example of autonomy.
Term

When an older nurse complains that nurses just aren’t eth-ical anymore, which reply reflects the best understandingof moral development?

a.“The ability to behave ethically must be carefullycultivated; maybe we don’t value this sufficiently topay it the attention it deserves.”

b.“I don’t agree that nurses were more ethical in thepast. It’s a new age and the ethics are new!”

c.“Ethics is genetically determined . . . it’s like havingblue or brown eyes. Maybe we’re evolving out ofthe ethical sense you and your generation had.”

d.“No kidding! Who could be ethical in a practice setting like this!”

Definition
a.The ability to be ethical, to make decisions, and toact in an ethically justified manner, begins in childhoodand develops gradually.
Term

A home health nurse who performs a careful safetyassessment of the home of a frail elderly patient to pre-vent harm to the patient is acting in accord with whichof the principles of bioethics?

a.Autonomy

b.Beneficence

c.Justiced.Fidelity

e.Nonmaleficence

Definition
e.Nonmaleficence is defined as the obligation toprevent harm. Autonomy is respect for another’s rightto make decisions, beneficence obligates us to benefitthe patient, justice obligates us to act fairly, and fidelityobligates us to keep our promises.
Term

A professional nurse committed to the principle of

autonomy would be careful to:

a.Provide the information and support a patientneeded to make decisions to advance her owninterests

b.Treat each patient fairly, trying to give everyone hisor her due

c.Keep any promises made to a patient or another pro-fessional caregiver

d.Avoid causing harm to a patient

Definition
a.The principle of autonomy obligates us to provide theinformation and support patients and their surrogatesneed to make decisions that advance their interests.
Term

A friend asks you about the new Bill of Rights fornurses. What can you tell her that accurately reflectsthe concerns of the drafters of these rights?

a.The Bill of Rights was drafted by nurses who care more about themselves than they do aboutpatients.

b.The Bill of Rights was drafted by union nurses whoare always looking for a reason to strike.

c.The Bill of Rights was drafted to empower nursesand to improve conditions in the workplace.

Definition
c.The American Nurses Association’s Bill of Rightsfor Registered Nurses was a result of advocacy onbehalf of nurses, to aid in improving workplaces andto ensure that nurses would have what they needed toprovide safe, quality patient care. It is not true thatthese nurses cared more for themselves than patients(a) nor that these were nurses looking for reasons tostrike (b).
Term

Janie wants to call an ethics consult to clarify treatmentgoals for a patient no longer able to speak for himself.She believes his dying is being prolonged painfully. She is troubled when the patient’s doctor tells her that she’llbe fired if she raises questions about his care or calls theconsult. This is a good example of:

a.Ethical uncertainty

b.Ethical distress

c.Ethical dilemma

Definition
b.Ethical distress results from knowing the right thingto do but finding it almost impossible to executebecause of institutional or other constraints (in thiscase, fear of losing her job). Ethical uncertainty (a) results from feeling troubled by a situation but notknowing if it is an ethical problem. Ethical dilemmasoccur when the principles of bioethics justify two ormore conflicting courses of action (c).
Term

Nurse advocates often are conflicted about respecting apatient’s right to be self-determining, while at the sametime wanting to do everything in their power to promotethe patient’s best interests. Which is the best generalguideline for situations like these?

a.Patient rules! “It’s my life!”

b.Nurse rules! “It may be your life, but in this instanceyou don’t know enough to make the right choice!”

c.When in conflict, weigh the benefits and risks offollowing each option and then choose wisely.

Definition
c.Neither respecting and supporting patientpreferences (a) nor ignoring patient preferences toachieve a medical benefit (b) routinely trump all otherconsiderations. When a nurse cannot do both simulta-neously, she must carefully weigh the benefits and risksof each option and then choose wisely.
Term

When a state attorney decides to charge a nurse withmanslaughter for allegedly administering a lethal med-ication order, this is an example of what type of law?

a.Public law

b.Private law

c.Civil law

d.Criminal law

Definition
d.Criminal law concerns state and federal criminalstatutes, which define criminal actions such as murder,manslaughter, criminal negligence, theft, and illegalpossession of drugs.
Term

If you wanted to find a list of the violations that canresult in disciplinary actions against a nurse, youshould read which of the following?

a.Nurse Practice Act

b.Code of Ethics for Nurses

c.Nurses’Bill of Rights

d.American Journal of Nursing

Definition
a.Each state has a Nurse Practice Act that protects thepublic by broadly defining the legal scope of nursingpractice. Practicing beyond those limits makes you vul-nerable to charges of violating the state Nurse PracticeAct. Nurse Practice Acts list the violations that canresult in disciplinary actions against a nurse and alsoserve to exclude untrained or unlicensed people frompracticing nursing.
Term

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license.

 

Those bringing the charges against Jean are called:

a.Appellates

b.Defendants

c.Plaintiffs

d.Attorneys

Definition
c.The person or government bringing suit againstanother is called the plaintiff.
Term

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license.

 

Jean’s attorney was careful to explain in her defensethat Jean had specialty knowledge, experience, andclinical judgment and had met certain criteriaestablished by a nongovernmental association, as aresult of which she was granted recognition in a speci-fied practice area. What is this sort of credential called?

a.Accreditation

b.Licensure

c.Certification

d.Board approval

Definition
c.Certification is the process by which a person whohas met certain criteria established by a non-governmental association is granted recognition in aspecified practice area.
Term

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license.

 

If review of this patient’s record revealed that she hadnever consented to the eye surgery, of which intentionaltort might the surgeon have been guilty?

a.Assault

b.Battery

c.Invasion of privacy

d.False imprisonment

Definition
b.Assault (a) is a threat or an attempt to make bodilycontact with another person without that person’s con-sent. Battery (b) is an assault that is carried out. Everyperson is granted freedom from bodily contact byanother person unless consent is granted.
Term

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license.

 

What must be established to prove that malpractice ornegligence has occurred in this case?

a.The surgeon who performed the procedure calledthe nurse’s action pure negligence, saying thepatient could have been saved.

she was a vibrant grandmother of 10 who hadwalked three quarters of a mile the morning of hersurgery and had sung in her church choir the daybefore.

c.The nurse intended to harm the patient and was will-fully negligent.

d.The nurse had a duty to monitor the patient’s vitalsigns, failed to do so, the patient died, and it wasJean’s failure to do her duty that caused the patient’sdeath.

Definition
d.Liability involves four elements that must be estab-lished to prove that malpractice or negligence hasoccurred: duty, breach of duty, causation, and damages.Duty refers to an obligation to use due care (what a rea-sonably prudent nurse would do) and is defined by thestandard of care appropriate for the nurse–patient rela-tionship. Breach of duty is the failure to meet the stan-dard of care. Causation, the most difficult element ofliability to prove, shows that the failure to meet thestandard of care (breach) actually caused the injury.Damages are the actual harm or injury resulting to thepatient.
Term

“Jean,” a veteran nurse, pleaded guilty to amisdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into acoma during routine outpatient eye surgery at an eyesurgery center. Jean admitted she failed to monitorthe woman’s vital signs during the procedure. Thesurgeon who performed the procedure called thenurse’s action pure negligence, saying the patientcould have been saved. The patient was a vibrantgrandmother of 10 who had walked three quarters ofa mile the morning of her surgery and had sung in her church choir the day before. As part of her pleaarrangement, the nurse agreed to serve 6 months ofprobation—the first 2 months on house arrest—andsurrender her nursing license

 

When the attorney representing the patient’s familycalls Jean and asks to talk with her about the case sothat he can better understand her actions, how shouldJean respond?

a.“I’m sorry, but I can’t talk with you. You’ll have tocontact my attorney.”

b.Answer the attorney’s questions honestly and makesure that he understands her side of the story.

c.Appeal to the attorney’s sense of compassion and tryto enlist his sympathy by telling him how busy itwas that morning.

d.“Why are you doing this to me? This could ruinme!”

Definition
a.One of the cardinal rules for nurse defendants is: Donot discuss the case with anyone at your agency (withthe exception of the risk manager), with the plaintiff,with the plaintiff’s lawyer, with anyone testifying forthe plaintiff, or with reporters.
Term

If you harm a patient by administering a medication(wrong drug, wrong dose, etc.) ordered by a physician,which of the following is true?

a.You are not responsible, since you were merely fol-lowing the doctor’s orders.

b.Only you are responsible, since you actually admin-istered the medication.

c.Only the physician is responsible, since he or sheactually ordered the drug.

d.Both you and the physician are responsible for your respective actions.

Definition
d.Nurses are legally responsible for carrying out theorders of the physician in charge of a patient unless anorder would lead a reasonable person to anticipateinjury if it were carried out. If the nurse should haveanticipated injury and did not, both the prescribingphysician and the administering nurse are responsiblefor the harms to which they contributed.
Term

A friend tells you not to even think about carrying yourown insurance because “you’ll be a magnet forattorneys trying to make a buck.” When you seek theadvice of the American Nurses Association, you arelikely to read which of the following reasons for purchasing a personal professional liability insurancepolicy?

(1)Protection of the nurse’s best interests

(2)Limitations of employer’s coverage

(3)Care or advice given outside of work

(4)Protection of the institution’s best interests

a.(1)

b.(1) and (2)

c.(1), (2), (3)

d.All of the above

Definition
c.The ANA (1990) lists reasons (1), (2), and (3) for pur-chasing a personal professional liability insurance policy.
Term

A fellow student asks you about your legal liabilitywhen you do your clinical practice. Which of thefollowing are true?

(1)Student nurses are responsible for their own acts ofnegligence if these result in patient injury.

(2)Students nurses are held to the same standard ofcare that would be used to evaluate the actions of aregistered nurse.

(3)A hospital may also be held liable for thenegligence of a student nurse enrolled in ahospital-controlled program because the student isconsidered an employee of the hospital.

(4)Nursing instructors may share a student’s responsi-bility for damages in the event of patient injury ifthe instructor failed to provide reasonable and pru-dent clinical supervision.

a.(1) and (3)

b.(2) and (4)

c.(1), (2), (3)

d.All of the above

Definition
d.All of the answers are true.
Term

A group of students are reviewing information abouthospitals in preparation for a quiz the next day. Whichof the following, if identified by the students as associ-ated with a hospital, demonstrates the need foradditional study?

a.Provision of acute care

b.Inpatient services

c.Outpatient services

d.Parish nursing activities

Definition
d.Hospitals are acute care providers, providingservices to both inpatients and outpatients.
Term

Which type of healthcare facility employs the largestpercentage of RNs?

a.Ambulatory care

b.Long-term care

c.Hospitals

d.Physician offices

Definition
c.Despite a downward trend, the largest percent ofRNs are employed by hospitals.
Term

When reviewing information about the growth of health-care services, which area would the nurse expect to findas the most rapidly growing area?

a.Hospitals

b.Home care

c.Nursing homes

d.Parish nursing

Definition
b.Home care services are the most rapidly growingarea of healthcare.
Term

Which healthcare provider is a major source of healthassessment and health education for children?

a.Hospital emergency department

b.Community center

c.Nurse practitioner

d.School nurse

Definition
d.School nurses do provide much of the health assess-ment and health information for the nation’s children.
Term

A caregiver asks a nurse to explain respite care. Howwould the nurse respond?

a.“A service that allows time away for caregivers”

b.“A special service for the terminally ill and theirfamily”

c.“Direct care provided to individuals in nursing homes”

d.“Living units for people without regular shelter”

Definition
a.Respite care is provided to enable a primarycaregiver time away from the day-to-day responsibili-ties of homebound patients.
Term

After teaching a class about the various healthcareagencies and services, the instructor determines that theteaching was successful when the class identifies whichof the following as a government agency?

a.Alcoholics Anonymous

b.Public Health Service

c.Rural health center

d.Ambulatory care center

Definition
b.The Public Health Service is a government agency.
Term

Which purpose best describes managed care as a frame-work for healthcare?

a.A design to control the cost of care while maintain-ing the quality of care

b.Care coordination to maximize positive outcomes tocontain costs

c.The delivery of services from initial contact throughongoing care

d.Based on a philosophy of ensuring death in comfortand dignity

Definition
a.Managed care is a way of providing care, designedto control costs while maintaining the quality of care.
Term

Your newly employed friend is a part of the company’sHMO. You interpret that to mean the friend

a.Can have healthcare services from a provider of hischoice

b.Will be unable to have emergency care

c.Receives all healthcare from providers within theorganization

d.Must pay an additional monthly premium

Definition
c.In most HMOs, the patient does not have a choice ofhealthcare providers and receives all services fromproviders within the HMO.
Term

Private insurance most often is called a third-partypayer, indicating which of the following?

a.You pay no monthly premium, paying for all health-care costs yourself.

b.You belong to a preferred provider organization.

c.You are at risk if your healthcare provider is not apart of the plan.

d.You pay a monthly premium, and the insurancecompany pays the bills.

Definition
d.You (and your employer, if appropriate) pay monthlypremiums, and the insurance company pays all or mostof the cost of care.
Term

A nurse is developing a presentation for a localcommunity group about the knowledgeable healthcareconsumer. Which technology would the nurse includeas having the greatest effect on this area?

a.Television

b.Computers

c.Cell phones

d.Global positioning system (GPS) devices

Definition
b.Consumers are increasingly using their home comput-ers to access healthcare information through the Internet.
Term

A group of students are reviewing information abouthospitals in preparation for a quiz the next day. Whichof the following, if identified by the students as associ-ated with a hospital, demonstrates the need foradditional study?
a.Provision of acute care

b.Inpatient services

c.Outpatient services

d.Parish nursing activities

Definition
d.Hospitals are acute care providers, providingservices to both inpatients and outpatients.
Term

Which type of healthcare facility employs the largest percentage of RNs?

a.Ambulatory care

b.Long-term care

c.Hospitals

d.Physician offices

Definition
c.Despite a downward trend, the largest percent of RNs are employed by hospitals.
Term

When reviewing information about the growth of health-care services, which area would the nurse expect to findas the most rapidly growing area?

a.Hospitals

b.Home care

c.Nursing homes

d.Parish nursing

Definition
b.Home care services are the most rapidly growingarea of healthcare.
Term

Which healthcare provider is a major source of healthassessment and health education for children?

a.Hospital emergency department

b.Community center

c.Nurse practitioner

d.School nurse

Definition
d.School nurses do provide much of the health assess-ment and health information for the nation’s children.
Term

A caregiver asks a nurse to explain respite care. Howwould the nurse respond?

a.“A service that allows time away for caregivers”

b.“A special service for the terminally ill and theirfamily”

c.“Direct care provided to individuals in nursing homes”

d.“Living units for people without regular shelter”

Definition
a.Respite care is provided to enable a primarycaregiver time away from the day-to-day responsibili-ties of homebound patients.
Term

After teaching a class about the various healthcareagencies and services, the instructor determines that theteaching was successful when the class identifies whichof the following as a government agency?

a.Alcoholics Anonymous

b.Public Health Service

c.Rural health center

d.Ambulatory care cente

Definition
b.The Public Health Service is a government agency.
Term

Which purpose best describes managed care as a frame-work for healthcare?

a.A design to control the cost of care while maintain-ing the quality of care

b.Care coordination to maximize positive outcomes tocontain costs

c.The delivery of services from initial contact throughongoing care

d.Based on a philosophy of ensuring death in comfortand dignity

Definition
a.Managed care is a way of providing care, designedto control costs while maintaining the quality of care.
Term

Your newly employed friend is a part of the company’sHMO. You interpret that to mean the friend

a.Can have healthcare services from a provider of hischoice

b.Will be unable to have emergency care

c.Receives all healthcare from providers within theorganization

d.Must pay an additional monthly premium

Definition
c.In most HMOs, the patient does not have a choice ofhealthcare providers and receives all services fromproviders within the HMO.
Term

Private insurance most often is called a third-partypayer, indicating which of the following?

a.care costs yourself.

b.You belong to a preferred provider organization.

c.You are at risk if your healthcare provider is not apart of the plan.

d.You pay a monthly premium, and the insurancecompany pays the bills.

Definition
d.You (and your employer, if appropriate) pay monthlypremiums, and the insurance company pays all or mostof the cost of care.
Term

A nurse is developing a presentation for a localcommunity group about the knowledgeable healthcareconsumer. Which technology would the nurse includeas having the greatest effect on this area?

a.Television

b.Computers

c.Cell phones

d.Global positioning system (GPS) devices

Definition
b.Consumers are increasingly using their home comput-ers to access healthcare information through the Interne
Term

A nurse is the discharge planner at a large metropolitanhospital. What would the nurse do to ensure continuityof care as patients move from acute care to home care?

a.Perform an admission health assessment

b.Participate in the transfer of patients to the ICU

c.Make referrals to appropriate agencies

d.Maintain records of patient satisfaction withservices

Definition
c.Making appropriate referrals for patients as theymove from acute care to home care is an essentialcomponent of discharge planning for continuity ofcare.
Term

Which of the following phrases best describes the phi-losophy of community-based care?

a.It considers the healthcare needs of the communityas a whole.

b.It centers on individuals and families with acute andchronic illness needs.

c.It has a population-based focus, with an emphasison illness prevention.

d.It provides direction for the roles of the nurse in theacute care setting.

Definition
b.Community-based care centers on individuals and families with acute and chronic healthcare needs.
Term

When admitting a patient to the hospital, the nurse may delegate some activities to other members of thehealthcare team. Which activity would be appropriateto delegate?

a.Collecting information for a health history

b.Performing a physical assessment

c.Contacting the physician for medical orders

d.Preparing the bed and collecting needed supplies

Definition
d.The nurse may delegate preparation of the bed andcollection of needed supplies to unlicensed personnelbut would perform the other activities listed.
Term

Based on the Health Insurance Portability and Account-ability Act (HIPAA), a patient admitted to a healthcarefacility must be provided with a written explanation of:

a.The names and addresses of responsible providers

b.A Patient’s Bill of Rights

c.How health information will be used and disclosed

d.How often family members or friends may visit orcall

Definition
c.HIPAA ensures privacy of information use anddisclosure.
Term

A patient is being transferred from the ICU to a regularhospital room. What must the ICU nurse be prepared todo as part of this transfer?

a.Provide a verbal report to the nurse on the new unit

b.Provide a detailed written report to the unit secretary

c.Delegate the responsibility for providing information

d.Make a copy of the patient’s medical record

Definition
a.The ICU nurse gives a verbal report about thepatient’s condition and nursing care needs to the nurseon the new unit. This information is not given to a unitsecretary, nor is it delegated to others. The medicalrecord is transferred with the patient; a copy is notmade.
Term

At what point during a hospital stay should dischargeplanning be initiated?

a.After surgery and successful recovery

b.After the patient is less anxious

c.Immediately before discharge

d.On admission to the acute care setting

Definition
d.Effective discharge planning begins on admission.
Term

Which of the following statements or questions wouldbe appropriate in establishing a discharge plan for apatient who has had major abdominal surgery?

a.“I’ll bet you will be so glad to be home in your ownbed.”

b.“What are your expectations for recovery from yoursurgery?”

c.“Be sure and take your pain medications and changeyour dressing.”

d.“You will just be fine! Please stop worrying.”

Definition
b.It is important to assess the expectations of thepatient (and family) when assessing healthcare needsfor discharge planning.
Term

A patient who decides to leave the hospital againstmedical advice (AMA) must sign a form. What is thepurpose of this form?

a.To indicate the patient’s wishes

b.To use in the event of readmission

c.To release the physician and hospital from legalresponsibility for the patient’s health status

d.To ethically illustrate that the patient has control ofhis or her own care and treatment

Definition
c.Patients who leave the hospital AMA sign a formreleasing the physician and hospital from legal respon-sibility for their health status. This signed formbecomes part of the medical record.
Term

What is the primary purpose of the identificationbracelet worn by hospitalized patients?

a.Safety

b.Communication

c.Advocacy

d.Legality

Definition
a.The identification bracelet is a safety measure ensur-ing that the correct patient is given medications, hassurgery, and so forth.
Term

The Patient Care Partnership form, given to patients onadmission to the hospital, includes several specificrights during hospitalization. Which of the following isincluded in this form?

a.The right to wear one’s own bed clothing

b.The right to use a personal cell phone

c.The right to have help when leaving the hospital

d.The right to take medications brought from home

Definition
c.One item on the Patient Care Partnership form is theright to have help when leaving the hospital.
Term

1.Which one of the following statements is a requirementfor Medicare home healthcare reimbursement?

a.The patient must be essentially homebound.

b.The patient must require intravenous therapy.

c.The caregiver must be able to provide all physicalcare.

d.The caregiver must live with the patient.

Definition
a.To be eligible for Medicare reimbursement, thepatient must be essentially homebound, or normallyunable to leave the home unassisted.
Term

n general, how does home care nursing compare withhospital-based nursing?

a.Nursing care provided in the home is no differentfrom hospital-based nursing care.

b.Home care patients do not have the same basic needsas those in the hospital.

c.In the home, care must be adapted to the patient’sschedules and customs.

d.The family or caregiver’s role is less important inhome care nursing.

Definition
c.In the hospital, patients must conform to establishedschedules for treatments, medications, meals, andvisitors. In contrast, in the home it is the patient or care-giver who establishes the schedule and controls the envi-ronment.
Term

3.Although the home care nurse follows an established planof care, he or she is more independent in what role?

a.Deciding which physician orders can be followed

b.Assuming responsibility for decision making

c.Shifting accountability for care to family caregivers

d.Delegating advanced clinical skills to unlicensed per-sonnel

Definition
b.The home healthcare nurse is more independent andassumes responsibility for decision making.
Term

Although all of the following skills are important, whatwould be the mostimportant to effective coordination ofcare and services?

a.Physical assessment

b.Knowledge of the law

c.How to use equipment

d.Effective communication

Definition
d.The home healthcare nurse must use effectivecommunication skills with other healthcare providerswhile coordinating services for the patient.
Term

Which of the following activities would the nurse do inthe pre-entry phase of the home visit?

a.Call the physician for a referral order

b.Conduct a health history and physical assessment

c.Collect information and schedule a visit

d.Establish mutually acceptable goals for care

Definition
c.During the pre-entry phase of the home visit, thenurse collects information and schedules the first visit.
Term

Before washing her hands, what might a home healthnurse ask or say to the patient?

a.“I need to wash my hands. May I use your bathroom?”

b.“I’m going to wash my hands in your bathroom.”

c.“I will wash my hands after I leave so I don’t botheryou.”

d.“How often do you wash your hands?”

Definition
a.The nurse must ask permission before rearranging fur-niture or using facilities for handwashing.
Term

What one activity is most important in preventing infec-tion when providing home care?

a.Wearing gloves whenever touching the patient

b.Following proper procedures for sterile dressingchanges

c.Asking the caregiver to step out of the room duringvisits

d.Performing hand hygiene before and after care

Definition
d.Performing hand hygiene before and after caring forthe patient is critical in preventing infection.
Term

How often must a home care nurse document progressnotes?

a.Once a week

b.At the initial visit

c.At each visit

d.At the final visit

Definition
c.The home health nurse must document progress notesat each visit.
Term

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

 

1.The nursing activity represented as (1) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Definition
a.(1) is an illustration of the collection of patient data.
Term

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

 

The nursing activity represented as (2) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Definition
b.(2) is an illustration of the identification of a nursingdiagnosis, a health problem that independent nursingintervention can resolve.
Term

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

 

The nursing activity represented as (2) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Definition
b.(2) is an illustration of the identification of a nursingdiagnosis, a health problem that independent nursingintervention can resolve.
Term

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

 

.The nursing activity represented as (3) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Definition
e.(3) is an illustration of outcome identification andrelated nursing interventions.
Term
Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.
Definition

The nursing activity represented as (4) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Term

Annie seeks your help in the student health clinic becauseshe suspects that her roommate Angela suffered date rape.She is concerned because Angela chose not to report therape and does not seem to be coping well. (1) After talkingwith Annie, you learn that although Angela blurted outthat she had been raped when she first came home, sincethen she has refused verbalization about the rape (“I don’twant to think or talk about it”), has stopped attending allcollege social activities (a marked change in behavior),and seems to be having nightmares.After analyzing thedata, you believe that Angela might be experiencing (2)rape-trauma syndrome: silent reaction.Fortunately,Angela trusts Annie and is willing to come to the studenthealth center for help. After a conversation with Angelaconfirms your suspicions and problem identification, youtalk with Angela (3) to develop some treatment goals thatyou formulate as outcomes and begin to think about thetypes of nursing interventions most likely to yield the out-comes you both seek.In your initial meeting with Angela,(4) you encourage her expression of feelings and help herto identify personal coping strategies and strengths.Youand Angela decide to meet in 1 week(5) to assess herprogress toward achieving targeted outcomes.If she is notmaking progress, you might need to modify the plan of care.

 

The nursing activity represented as (5) is an example ofwhich step of the nursing process?

a.Assessing

b.Diagnosing

c.Evaluating

d.Implementing

e.Planning

Definition
c.(5) is an illustration of measuring the extent to whichAngela has achieved targeted outcomes.
Term

Which of the following statements about the nursingprocess is most accurate?

a.The nursing process is a four-step procedure foridentifying and resolving patient problems.

b.Beginning in Florence Nightingale’s days, nursingstudents learned and practiced the nursing process.

c.Use of the nursing process is optional for nurses, sincethere are many ways to accomplish the work of nursing.

d.The state board examinations for professional nurs-ing practice now use the nursing process rather thanmedical specialties as an organizing concept.

Definition
d.The nursing process is a five-step process (a); theterm nursing process was first used by Hall in 1955 (b);and standards demand the use of the nursing process(c), so it is not optional
Term

The nursing process ensures that nurses are patient cen-tered rather than task centered. Rather than simplyapproaching a patient to take vital signs, the nursethinks “How is Mrs. Barclay today? Are our nursingactions helping her to achieve her goals? How can webetter help her?” This demonstrates which characteris-tic of the nursing process?

a.Systematic

b.Interpersonal

c.Dynamic

d.Universally applicable in nursing situations

Definition
b,interpersonal. Each of the other options are charac-teristics of the nursing process, but the conversationand thinking quoted best illustrates the interpersonaldimension of the nursing process.
Term

An experienced nurse tells you not to bother studyingtoo hard, since most clinical reasoning becomes “sec-ond nature” and “intuitive” once you start practicing.What thinking below should underlie your response?

a.When intuition is used alone, there are increasedrisks and fewer benefits. Intuition often moves prob-lem solving forward quickly, but it might result in alot of trial-and-error approaches.

b.For nursing to remain a science, nurses must continueto be vigilant about stamping out intuitive reasoning.c.The emphasis on logical, scientifi

c, evidence-basedreasoning has held nursing back for years. It’s timeto champion intuitive, creative thinking!

d.It’s simply a matter of preference. Some of us arelogical, scientific thinkers, and some are intuitive,creative thinkers.

Definition
a.When intuition is used alone, there are increasedrisks and fewer benefits. Intuition often moves problemsolving forward quickly, but it might result in a lot oftrial-and-error approaches. Answer bis incorrectbecause there is a place for intuitive reasoning in nurs-ing, but it will never replace logical, scientific reason-ing (c). Critical thinking is contextual and changesdepending on the circumstances, not on personal preference (d).
Term

This text is based upon a notion of blended skills. Sim-ply described, what does this mean?

a.Nursing works best when nurses competently usethe intellectual and technical skills that achievepatient outcomes. Nursing has been held back byoutdated notions of care and compassion (interper-sonal skills), which can be done by anyone.

b.Nursing works best when each nurse competentlyuses the intellectual, interpersonal, technical, andethical/legal skills demanded by each situation.

c.All of the blended skills are important, but not everynurse has to be skilled in each area. We benefitpatients by knowing what we do best. I might beutterly deficient in interpersonal skills but excellentin intellectual skills.

d.Every nursing situation demands the same blend ofbasic nursing skills, intellectual, technical, interper-sonal, and ethical/legal.

Definition
b.Every nurse must be competent in all four basicskill areas and judge what skills each situationneeds. Each situation is unique and might call for adifferent “blend” of basic skills.
Term

The best description of critical thinking indicators(CTIs) is which of the following?

a.Evidence-based descriptions of behaviors thatdemonstrate the knowledge that promotes criticalthinking in clinical practice

b.Evidence-based descriptions of behaviors thatdemonstrate the knowledge and skills that promotecritical thinking in clinical practice

c.Evidence-based descriptions of behaviors thatdemonstrate the knowledge, characteristics, and skills that promote critical thinking in clinicalpractice

d.Evidence-based descriptions of behaviors thatdemonstrate the knowledge, characteristics,standards, and skills that promote critical thinking inclinical practice

Definition
c,evidence-based descriptions of behaviors thatdemonstrate the knowledge, characteristics, and skills that promote critical thinking in clinical practice.
Term

Although the nursing process is presented as an orderlyprogression of steps, in reality there is great interactionand overlapping among the five steps. Which of the fol-lowing describes this characteristic of the nursingprocess?

a.Systematic

b.Dynamic

c.Interpersonal

d.Outcome oriented

Definition
b.The term dynamic is used to describe the fact thatthere is much interaction and overlap among the stepsof the nursing process. In some situations, all ve stepsmay occur almost simultaneously.
Term

While administering a medication to relieve a patient’spain, you wonder if there are some nonpharmacologicinterventions that would enhance relief by complement-ing the pain medication. When you discuss this questionwith your instructor, which of the following responsesare you most likely to hear?

a.“You should wait until after you evaluate the effectof the medication you just administered before plan-ning a different intervention.”

b.“One step at a time. Don’t start planning a newintervention until you evaluate the old.”

c.“Let’s talk about this . . . we often get new informa-tion that we can incorporate successfully into theplan of care. Sometimes the steps of the processinteract or overlap.”

d.“Think about this patient. Nonpharmacologic inter-ventions wouldn’t be effective with her.”

Definition
c.There may be much interaction and overlap amongthe steps of the nursing process. In this case, thoughyou want to evaluate the effect of the medication youadministered (options aandb), there is no reason towait for this to happen before exploring other validoptions. Answer dis incorrect because it is not possibleto judge the effectiveness of nonpharmacologic meth-ods before their use, and the instructor’s response pos-sibly indicates a prejudice toward complementary andalternative modalities.
Term

When a patient you are admitting to the unit asks youwhy you are doing a history and exam since the doctorjust did one, which of the following statements is yourbest reply?

a.“In addition to providing us with valuable informa-tion about your health status, the nursing assessmentwill allow us to plan and deliver individualized,holistic nursing care that draws on your strengths.”

b.“It’s hospital policy. I know it must be tiresome, butI will try to make this quick!”

c.“I’m a student nurse and need to develop the skill ofassessing your health status and need for nursingcare. This information will help me develop a planof care individualized to your unique needs.”

d.“We want to make sure that your responses are con-sistent and that all our data are accurate.”

Definition
a.Though it may be true that you need to developassessment skills (c), the chief reason you are doinga nursing history and exam is because there needs tobe a documented nursing admission assessment toserve as a basis for nursing care. The fact that this isalso hospital policy (b) is a secondary reason.
Term

When you receive the shift report, you learn that your patient has no special skin care needs. You aresurprised during the bath to observe reddened areasover bony prominences. What action is appropriate?

a.Correct the initial assessment form.

b.Redo the initial assessment and document currentfindings.

c.Conduct and document an emergency assessment.

d.Perform and document a focused assessment on skinintegrity.

Definition
d.Perform and document a focused assessmenton skin integrity since this is a newly identiedproblem. The initial assessment stands as is andcannot be redone (b) or corrected (a). This is not alife-threatening event; thus, there is no need for anemergency assessment (c).
Term

Fearful of attempting your first nursing history, you ask your instructor how anyone ever learns every-thing you have to ask to get good baseline data. Youare most likely to hear which reply from theinstructor?

a.“There’s a lot to learn at first, but once it becomespart of you, you just keep asking the same questionsover and over in each situation until you can do it inyour sleep!”

b.“You make the basic questions a part of you andthen learn to modify them for each unique situation,asking yourself how much you need to know to plangood care.”

c.“No one ever really learns how to do this wellbecause each history is different! I often feel likeI’m starting afresh with each new patient.”

d.“Don’t worry about learning all of the questions toask. Every agency has its own assessment form youmust use.”

Definition
b.Once you learn what constitutes the minimum dataset, you can adapt this to any patient situation. It is nottrue that each assessment is the same even when youare using the same minimum data set (a), nor is it truethat each assessment is uniquely different (c). Answer dis incorrect because relying solely on standard agencyassessment tools does not allow for individualizedpatient care or critical thinking.
Term

A patient complains about feeling nauseated afterlunch. This is an example of what type of data?

a.Subjective

b.Objective

c.Signs and symptoms

d.Overt

Definition
a.A patient report of “feeling nauseated” cannot be per-ceived or validated by the nurse, and this is subjectivedata, not objective (b) or overt (d), which are observableddand measurable. Answer cis wrong because signs areexamples of objective data.
Term

When you enter the patient’s room to begin your nurs-ing history, the patient’s wife is there. What shouldyou do?

a.Introduce yourself to both and thank the wife forbeing present.

b.Introduce yourself to both and ask the wife if shewants to remain.ourself to both and ask the wife to

c. Introduce yourself to both and ask the wife to leave.

d. Introduce yourself and ask the patient if he wouldd Intrlike the wife to stay.

Definition
d.The patient has the right to indicate who hewould like to be present for the nursing history andexam. You should neither presume that he wants hiswife there (a), nor that he does not want her there (c).Similarly, the choice belongs to the patient, not thewife (b).
Term

The patient is Vietnamese and does not speak English.Her son is with her and does speak English. Howshould you respond?

a. Ask the son if he is willing to translate and be sureto thank him if he says yes.

b. Determine if the son can translate medical informa-tion and if so, begin.

c. After determining that the son can translate, evalu-ate if he can do so objectively and if the patientwants him to serve in this capacity.

d. Explain to the patient and her son that you willobtain the services of a hospital-approvedtranslator.

Definition
d.Even if the son is able and willing to translate,best practice now dictates using approved translators.Family dynamics often make discussions about theintimate details of medical conditions and treatmentdifcult.
Term

You are surprised to detect an elevated temperature(102F) in a patient scheduled for surgery. The patienthas been afebrile and shows no other signs of beingfebrile. What is the first thing you do?

a. Inform the charge nurse

b. Inform the surgeon

c. Validate your  finding

d. Document your finding

Definition
c.You should first validate your finding if it isunusual, deviates from normal, and is unsupportedby other data. Should your initial recording proveto be in error, it would have been premature to notifythe charge nurse (a) or the surgeon (b). You wantto be sure that all data you record is accurate, so itshould be validated before documentation if you have doubts (d).
Term

You tell your instructor that your patient is ne and has“no complaints.” You are likely to hear:

a. “You made an inference that she is ne because shehas no complaints. How did you validate this?”

b. “She probably just doesn’t trust you enough to sharewhat she is feeling. I’d work on developing a trust-ing relationship.”

c. “Sometimes everyone gets lucky. Why don’t you tryto help another patient?”

d. “Maybe you should reassess the patient. He has tohave a problem—why else would he be here?

Definition
a.Your instructor is most likely to challenge your infer-ence that the patient is “ne” simply because he istelling you that he has no problems. It is appropriate forher to ask how you validated this inference. Jumping tothe conclusion that the patient does not trust you (b) ispremature and is an invalidated inference. Answer ciswrong because it accepts your invalidated inference.Answer dis wrong because it is possible that the condi-tion is resolving.
Term

Identify all of the following that are purposes of diagnosing. The purpose of diagnosing is to identify:(1)how an individual, group, or community respondsto actual or potential health and life processes(2)factors that contribute to or cause health problems(etiologies)(3)strengths the patient can draw on to prevent orresolve problems(4)nursing interventions to resolve health problems

a.(1) and (2)

b.(3) and (4)

c.(1), (2), and (3)

d.All of the above

Definition
c.Identifying nursing interventions to resolve healthproblems is done during the planning step of the nurs-ing process.
Term

The terms diagnoseand diagnosishave legal implica-tions. They imply that there is a specific problem thatrequires management by a qualified expert. Which ofthe following statements is false?

a.If you make a diagnosis, it means that you acceptaccountability for accurately naming and managingthe problem.

b.If you treat a problem or allow a problem to persistwithout ensuring that the correct diagnosis hasbeen made, you may cause harm and be accused of negligence.

c.You are accountable for detecting, identifying, orrecognizing signs and symptoms that may indicateproblems beyond your expertise.

d.When nurses diagnose a medical problem, they arejust as accountable as physicians for detecting,identifying, and managing the signs and symptomsof disease.

Definition
d.While nurses are accountable to identify anddocument nursing diagnoses and the signs andsymptoms suggestive of medical and collaborativeproblems, their responsibility for medical problems isrelated only to the scope of their practice and they donot share the same responsibility as their physiccian colleagues.
Term

Which was the first state to identify diagnosing as partof the legal domain of professional nursing?

a.New Jersey

b.New York

c.North Carolina

d.North Dakota

Definition

b.New York was the first state to identify diagnosing aspart of the legal domain of professional nursing.

Term

Which group is responsible for the promotion andorganization of activities to continue the development,classification, and scientific testing of nursingdiagnoses?

a.American Nurses Association

b.National Nursing Diagnosis Association

c.North American Nursing Diagnosis Association

d.Clearinghouse for Nursing Diagnoses

Definition
c,North American Nursing Diagnosis Association.
Term

Altered Health Maintenance is an example of which ofthe following types of problems?

a.Collaborative problem

b.Interdisciplinary problem

c.Medical problem

d.Nursing problem

Definition
d,Nursing Problem, because it describes a problemthat can be treated by nurses within the scope of inde-pendent nursing practice.
Term

To determine the significance of a blood pressure read-ing of 148/100, it is first necessary for the nurse to dowhich of the following?

a.Compare this reading to standards.

b.Check the taxonomy of nursing diagnoses for a pertinent label.

c.Check a medical text for the signs and symptoms ofhigh blood pressure.

d.Consult with colleagues.

Definition

a.A standard, or a norm, is a generally accepted rule,measure, pattern, or model to which can be compareddata in the same class or category. For example, whendetermining the signicance of a patient’s blood pres-sure reading, appropriate standards include normativevalues for the patient’s age group, race, and illness cat-egory. Deviation from an appropriate norm may be thebasis for writing a diagnosis.

Term

When the initial nursing assessment revealed that thepatient had not had a bowel movement for 2 days, the student wrote the diagnostic label “constipation.”Which of the following comments is she most likely to hear from her instructor?

a.“Hold on a minute . . . Nursing diagnoses shouldalways be derived from clusters of significant datarather than from a single cue.”

b.“Job well done . . . You’ve identified this problemearly and we can manage it before it becomes moreacute.”

c.“Is this an actual or a possible diagnosis?”

d.“This is a medical, not a nursing problem.”

Definition
a.A data cluster is a grouping of patient data or cues thatpoints to the existence of a patient health problem. Nurs-ing diagnoses should always be derived from clusters ofsignicant data rather than from a single cue. There maybe a reason for the lack of a bowel movement for 2 days,or it might be this individual’s normal pattern.
Term

A clinical judgment that an individual, family, or com-munity is more vulnerable to develop the problem thanothers in the same or similar situation is what type ofnursing diagnosis?

a.Actual

b.Risk

c.Possible

d.Wellness

e.Syndrome

Definition
b.A clinical judgment that an individual, family, orcommunity is more vulnerable to develop the problemthan others in the same or similar situation is a Risknursing diagnosis.
Term

Which of the following nursing diagnoses are correctlywritten as two-part nursing diagnoses?(1) Ineffective Coping related to inability to maintainmarriage(2) Defensive Coping related to loss of job andeconomic security(3) Altered Thought Processes related to panic state(4) Decisional Conict related to placement of parentin nursing home

a. (1) and (2)

b. (3) and (4)

c. (1), (2), and (3)

d. All of the above

Definition
d.Each of the four diagnoses is a correctly written two-part diagnostic statement that includes the problem ordiagnostic label and the etiology or cause.
Term

Which of the following nursing diagnoses are correctlywritten as three-part nursing diagnoses?(1) Disabled Family Coping related to lack of knowl-edge about home care of child on ventilator(2) Imbalanced Nutrition: Less Than Body Requirementsrelated to inadequate caloric intake while striving toexcel in gymnastics as evidenced by 20-pound weightloss since beginning the gymnastic program, andgreatly less than ideal body weight when comparedto standard height weight charts(3) Need to learn how to care for child on ventilatorat home related to unexpected discharge of daugh-ter after 3-month hospital stay as evidenced byrepeated comments “I cannot do this,” “I knowI’ll harm her because I’m not a nurse,” and “Ican’t do medical things.”(4) Spiritual Distress related to inability to accept diag-nosis of terminal illness as evidenced by multiplecomments such as “How could God do this tome?,” “I don’t deserve this,” “I don’t understand.I’ve tried to live my life well,” “How could Godmake me suffer this way?”(5) Caregiver Role Strain related to failure of homehealth aides to appropriately diagnose needs offamily caregivers and initiate a plan to facilitatecoping as evidenced by caregiver’s loss of weightand clinical depression.

a. (1) and (3)

b. (2) and (4)

c. (1), (2), and (3)

d. All of the above

Definition
b.(1) is a two-part diagnosis, (3) is written in terms ofneeds and not an unhealthy response, and (5) is alegally inadvisable statement.
Term

During the outcome identification and planning step ofthe nursing process, the nurse works in partnershipwith the patient and family to do which of the follow-ing? Select all that apply.

a.Formulate and validate prioritized nursing diagnoses

b.Identify expected patient outcomes

c.Select evidence-based nursing interventions

d.Communicate the plan of nursing care

Definition
b, c,and d.Formulating and validating nursing diag-noses (a) occur during the diagnosing step of thenursing process.
Term

Mr. Price tells the nurse he fears becoming “hookedon drugs” and consequently waits until his painbecomes unbearable before requesting his PRN analgesic. The nurse plans to be more attentive to Mr. Price and to assess his needs for pain managementmore closely. Which of the following consequences ofinformal planning ought to be the major concern forthis nurse?a.The lack of a coordinated plan known by everyonewill

result in uneven pain management.

b.Faulty prioritization of patient needs

c.Inability to evaluate the patient’s responses to nursing care

d.Lack of a record for reimbursement purposes

Definition
a.If this nurse fails to incorporate this learning into theformal plan of care, other professional caregivers willnot be aware of the need to monitor the patient’s painneeds more closely. b, c, and dmay all be correctresponses, but they should not be the major concern of the nurse.
Term

When helping Mr. Price turn in bed, the nurse noticesthat his heels are reddened and plans to place him onprecautions for skin breakdown. This is an example ofwhat type of planning?

a.Initial planning

b.Standardized planning

c.Ongoing planning

d.Discharge planning

Definition
c.Ongoing planning is problem oriented and has as itspurpose keeping the plan up to date as new actual orpotential problems are identified.
Term

For the following patient problems:(1)Disturbed Body Image(2)Ineffective Airway Clearance(3)Spiritual Distress(4)Impaired Social Interaction.Which answer choice below lists the problems in orderof highest priority to lowest priority based on Maslow’shierarchy of human needs?

a.2, 4, 1, 3

b.3, 1, 4, 2

c.1, 4, 3, 2

d.3, 2, 4, 1

Definition
a.Maslow’s hierarchy is (1) physiologic needs, (2) safetyneeds, (3) love and belonging needs, (4) self-esteemneeds, and (5) self-actualization needs. (2) is an exampleof a physiologic need, (4) is an example of a love andbelonging need, (1) is an example of a self-esteem need,and (3) is an example of a self-actualization need.
Term

From which of the following are nursing outcomesderived?

a.The problem statement of the nursing diagnosis

b.The etiology of the problem of the nursing diagnosis

c.The defining characteristics of the problem

d.The evaluative statement

Definition

a.Outcomes are derived from the problem statement ofthe nursing diagnosis. For each nursing diagnosis in theplan of care, at least one outcome should be writtenthat, if achieved, demonstrates a direct resolution of the problem statement.

Term

Which of the following is an example of an affectiveoutcome?

a.Within 1 day after teaching, the patient will listthree benefits of continuing to apply moistcompresses to leg ulcer after discharge.

b.By 6/12/12, the patient will correctly demonstrateapplication of wet-to-dry dressing on leg ulcer.

c.By 6/19/12, the patient’s ulcer will begin to showsigns of healing (e.g., size shrinks from 3"to 2.5").

d.By 6/12/12, the patient will verbalize valuing healthsufficiently to practice new health behaviors to pre-vent recurrence of leg ulcer.

Definition

d.Affective outcomes describe changes in patientvalues, beliefs, and attitudes. Cognitive outcomes (a) describe increases in patient knowledge or intellec-tual behaviors; psychomotor outcomes (b) describe thepatient’s achievement of new skills. cis an outcomedescribing a physical change in the patient.

Term

Which of the following is an optional element in ameasurable outcome?

a.Subject

b.Verb

c.Performance criteria

d.Conditionse.Target time

Definition
d.Conditions specify the particular circumstances in orby which the outcome is to be achieved. Not every out-come specifies conditions.
Term

Which of the following outcomes are correctly written?Select all that apply.

a.Offer Mr. Myer 60 mL fluid every 2 hours whileawake.

b.During the next 24-hour period, the patient’s fluidintake will total at least 2,000 mL.

c.Teach Mrs. Gaston proper newborn care by 1/15/11.

d.By discharge, Mrs. Gaston will know how to batheher newborn.

e.At the next visit, 12/23/11, the patient will correctlydemonstrate relaxation exercises.

Definition
bande.The outcomes in a and cmake the error ofexpressing the patient goal as a nursing intervention.Incorrect: “Offer Mr. Myer 60 mL fluid every 2 hourswhile awake.” Correct: “Mr. Myer will drink 60 mL fluidevery 2 hours while awake, beginning 1/3/11.” The outcome in dmakes the error of using verbs that are notobservable and measurable. Incorrect: “Mrs. Gastonwill know how to bathe her newborn.” Correct: “Afterattending the infant care class, Mrs. Gaston will correctlydemonstrate the procedure for bathing her newborn.”Verbs to be avoided when writing goals include “know,”“understand,” “learn,” and “become aware.”
Term

Which of the following guidelines for outcome writingare correct? Select all that apply.a.At least one of the outcomes shows

a direct resolutionof the problem statement in the nursing diagnosis.

b.The patient (and family) values the outcomes.

c.The outcomes are supportive of the total treatmentplan.

d.Each outcome is brief and specific (clearly describesone observable, measurable patient behavior/manifestation), is phrased positively, and specifiesa time line.

Definition
a, b, c,and d.
Term

Which of the following are examples of well-statednursing interventions? Select all that apply.

a.Offer patient 60 mL water or juice (prefers orangeor cranberry juice) every 2 hours while awake for atotal minimum PO intake of 500 mL.

b.Teach patient the necessity of carefully monitoringfluid intake and output; remind patient each shift tomark off fluid intake on record at bedside.

c.Walk with patient to bathroom for toileting every 2 hours (on even hours) while patient is awake.

d.Manage patient’s pain.

Definition
a, b,and c.The last item, d, lacks sufficient detail toeffectively guide nursing intervention. The set of nursinginterventions written to assist a patient to meet anoutcome must be comprehensive. Comprehensivenursing interventions specify what observations (assess-ments) need to be made and how often, what nursinginterventions need to be done and when they must bedone, and what teaching, counseling, and advocacy needspatients and families have.
Term

A school nurse notices that Jill is losing weight andwants to perform a focused assessment on Jill’snutritional status, fearing that she might have an eatingdisorder. How should the nurse proceed?

a.Perform the focused assessment. This is an independ-ent nurse-initiated intervention.

b.Request an order from Jill’s physician since this is aphysician-initiated intervention.

c.Request an order from Jill’s physician since this is acollaborative intervention.

d.Request an order from the nutritionist since this is acollaborative intervention.

Definition
a.Performing a focused assessment is an independentnurse-initiated intervention. The nurse, therefore, doesnot need an order from the physician (b,c) or the nutri-tionist (d).
Term

Which of the following would you expect to find in theNursing Interventions Classification Taxonomy?

a.Case studies illustrating a complete set of activitiesthat a nurse performs to carry out nursing interventions

b.Nursing interventions, each with a label, a definition,and a set of activities that a nurse performs to carry itout, with a short list of background readings

c.A complete list of nursing diagnoses, outcomes, andrelated nursing activities for each nursing intervention

d.A complete list of reimbursable charges for eachnursing intervention

Definition
b.The Nursing Interventions Classification Taxonomylists 336 interventions, each with a label, a definition, aset of activities that a nurse performs to carry it out, anda short list of background readings. It does not containcase studies (a), diagnoses (c), or charges (d).
Term

You are a brand new RN. When you orient to a newnursing unit that is currently understaffed, you are toldthat the UAPs have been trained to obtain the initialnursing assessment. What is the best response?

a.Allow the UAPs to do the admission assessment andreport the findings to you.

b.Do your own admission assessments but don’t inter-fere with the practice if other professional RNs seemcomfortable with the practice.

c.Tell the charge nurse that you are choosing not to del-egate the admission assessment at this time until youcan get further clarification from admission.

d.Contact your labor representative and complain.

Definition
c.You do not delegate this nursing admission assessmentbecause you learned that only nurses can perform thisintervention. You should seek clarification for this policyfrom nursing administration.
Term

Jeanne is a college student who wants to lose 20 pounds.She meets with the student health nurse and develops aplan to increase her activity level and decrease theconsumption of the wrong types of foods and excesscalories. The nurse plans to evaluate her weight lossmonthly. When Jeanne arrives for her first “weigh-in,”the nurse discovers that instead of the projected weightloss of 5 pounds, Jeanne has only lost 1 pound. Which isthe best nursing response?

a.Congratulate Jeanne and continue the plan of care.

b.Terminate the plan of care since it is not working.

c.Try giving Jeanne more time to reach the targetedoutcome.

d.Modify the plan of care after discussing possible rea-sons for Jeanne’s partial success

Definition
d.Since Jeanne has only partially met her outcome, thenurse should first explore the factors making it difficultfor Jeanne to reach her outcome and then modify the planof care. It would not be appropriate to continue the planas it is since it is not working (a), and it is premature toterminate the plan of care (b) since Jeanne has not mether targeted outcome. Jeanne may need more than timeto reach her outcome, which makes (c) the wrongresponse.
Term

The following are all classic elements of evaluation.Which item below places them in their correctsequence?

(1)Interpreting and summarizing findings

(2)Collecting data to determine whether evaluative criteria and standards are met

(3)Documenting your judgment

(4)Terminating, continuing, or modifying the plan

(5)Identifying evaluative criteria and standards (whatyou are looking for when you evaluate, e.g., expectedpatient outcomes)

a.(1), (2), (3), (4), (5)

b.(3), (2), (1), (4), (5)

c.(5), (2), (1), (3), (4)

d.(2), (3), (1), (4), (5)

Definition
c.This is a sequenced list.
Term

When a new nurse is oriented to the subacute unit, she istold that each nurse is expected to observe her patients atleast every hour, and more if their condition warrantsextra monitoring. This expectation is best termed:

a.Standard

b.Criteria

c.Custom

d.Order

Definition
a,standard, the levels of performance accepted andexpected by the nursing staff or other health team mem-bers. Criteria (b) are measurable qualities, attributes, orcharacteristics that specify skills, knowledge, or healthstates. Custom (c) sometimes establishes standards.Orders (d) are written to address the special needs of the patient.
Term

Remember Jeanne, the college student who wants to lose20 pounds? When the nurse weighs her during the fifthstep of the nursing process, what is she doing?

a.Collecting assessment data to identify healthproblems

b.Collecting assessment data to identify patientstrengths

c.Collecting evaluative data to justify terminating theplan of care

d.Collecting evaluative data to measure outcomeachievement

Definition
d,collecting evaluative data to measure outcomeachievement. While this may justify terminating the planof care (c), that is not necessarily so. Assessment data (a,b) are collected during the first step of the nursingprocess.
Term

One of the outcomes Jeanne and the nurse planned isthat Jeanne “appreciates or values a healthy body suffi-ciently to try to new behaviors.” Which of the followingbest describes this type of outcome?

a.Cognitive

b.Psychomotor

c.Affective

d.Physical changes

Definition
c.Affective outcomes pertain to changes in patient values,beliefs, and attitudes. Cognitive outcomes (a) involveincreases in patient knowledge; psychomotor outcomes(b) describe the patient’s achievement of new skills; phys-ical changes (d) are actually bodily changes in the patient(e.g., weight loss, increased muscle tone).
Term

Another of the outcomes Jeanne and the nurse planned isthat Jeanne “can explain the relationship between weightloss, increased exercise, and decreased calorie intake.”Which of the following best describes this type ofoutcome?

a.Cognitive

b.Psychomotor

c.Affective

d.Physical changes

Definition
a.Cognitive outcomes involve increases in patient knowl-edge; psychomotor outcomes (b) describe the patient’sachievement of new skills; affective outcomes (c) pertainto changes in patient values, beliefs, and attitudes; andphysical changes (d) are actually bodily changes in thepatient (e.g., weight loss, increased muscle tone).
Term

Which of the following is the correct example of anevaluative statement?

a.“Outcome not met.”

b.“1/21/09—Patient reports no change in tobacco use.”

c.“Outcome not met. Patient reports no change intobacco use.”

d.“1/21/09—Outcome not met. Patient reports nochange in tobacco use.”

Definition
d.The evaluative statement contains a date; the words“outcome met,” “outcome partially met,” or “outcome not met,” and the patient data or behaviors that support thisdecision. Answers a, b, and care incomplete statements.
Term

A quality-assurance program reveals a higher incidenceof falls and other safety violations on a particular unit. Anurse manager states, “We’d better find the folks respon-sible for these errors and see if we can’t replace them.”This is an example of which of the following?

a.Quality by inspection

b.Quality by punishment

c.Quality by surveillance

d.Quality by opportunity

Definition
a.Quality by inspection focuses on finding deficientworkers and removing them. Quality as opportunity(d) focuses on finding opportunities for improvementand fosters an environment that thrives on teamwork,with people sharing the skills and lessons they havelearned. Answers band care distractors.
Term

One nursing unit with an excellent safety record meetsto review the findings of the audit and the nurse managerstates, “We’re doing well, but we can do better! Who’sgot an idea to foster increased patient well-being andsatisfaction?” This is an example of leadership that values which of the following?

a.Quality assurance

b.Quality improvement

c.Process evaluation

d.Outcome evaluation

Definition
b.Unlike quality assurance (a), quality improvement isinternally driven, focuses on patient care rather thanorganizational structure, focuses on processes ratherthan individuals, and has no end points. Its outcome isimproving quality rather than assuring quality. Answerscand dare types of quality-assurance programs.
Term

Which of the following documentation guidelines arecorrect? Select all that apply.

a.Enter information in a complete, accurate, concise,factual, and organized manner.

b.Use words such as “good,” “average,” “normal,” or“sufficient” to communicate judgments about data.

c.Wait until the end of the shift to document nursinginterventions to ensure comprehensive charting.

d.Date and time each entry.

Definition
a and d.Both of these answers represent documentationguidelines that all nurses should follow.
Term

Which of the following documentation guidelines arecorrect? Select all that apply.

a.Erase or use correcting fluid to completely deletemistaken entries.

b.Document nursing interventions as closely as possi-ble to the time of their execution.

c.Note problems as they occur in an orderly, sequentialmanner.

d.Carefully document all the factors that compromisepatient safety and contribute to patient harm.

Definition
b and c.Both of these answers represent documentationguidelines that all nurses should follow.
Term

According to the Health Insurance Portability andAccountability Act of 1996, patients have a right towhich of the following? Select all that apply.

a.To see and copy their health record

b.To update their health record

c.To get a list of the disclosures a healthcare institutionhas made independent of disclosures made for thepurposes of treatment, payment, and healthcare operations

d.To request a restriction on certain uses or disclosures

e.To choose how to receive health information

Definition
a, b, c, d,and e.Each item is correct.
Term

According to the Health Insurance Portability andAccountability Act of 1996, if a health institution wants to release a patient’s health information forpurposes other than treatment, payment, and routinehealthcare operations, the patient must be asked tosign an authorization. There are exceptions to thisrequirement. In which case below is an authorizationneeded?

a.The patient is a public figure and the local newsmedia are preparing a news report.

b.Data are needed for the tracking and notification ofdisease outbreaks.

c.Child abuse and neglect are suspected.

d.Protected health information is needed to facilitateorgan donations.

Definition
a.Under no circumstance can a nurse provide informa-tion to a news reporter without the patient’s expressauthorization. Items b, c,and d, however, are legitimateexceptions to the authorization rule.
Term

A friend of yours calls you and asks if you are stillworking at Memorial Hospital. You reply “yes.” Hetells you that his girlfriend’s father was just admittedas a patient, and he wants you to find out how he is.“Sue (his girlfriend) seems unusually worried abouther dad, but she won’t talk to me and I want to be ableto help her.” What is the best response you can maketo your friend?

a.“Listen, you shouldn’t be asking me to do this. Icould be fined big bucks or even lose my job for disclosing this information.”

b.“Sorry, but I’m not able to give information aboutpatients to the public—even when my best friend or a family member asks.”

c.“Because of the Health Insurance Portability andAccountability Act, you shouldn’t be asking for thisinformation unless the patient has authorized you toreceive it! This could get you in trouble!”

d.“Why do you think Sue isn’t talking about herworries?”

Definition
b.You should immediately clarify what you can and can-not do. Since your primary reason for refusing to help islinked to your responsibility to protect patient privacyand confidentiality, you should not begin by mentioningthe real penalties linked to abuses of privacy (a,c).Finally, it is appropriate to ask about Sue and herworries, but this should be done after you clarify whatyou are able to do (d).
Term

Your patient has an order for an analgesic medication to be given as needed. The correct abbreviation for “as needed” is:

a.TURP

b.PMH

c.PRN

d.TPR

Definition
c.PRN means “as needed”. TURP (a) is transurethralresection of prostate; PMH (b) is past medical history;and TPR (d) is temperature, pulse, respiration.
Term

If you were looking for trends in a patient’s vital signs,what form should you consult first?

a.Admission sheet

b.Admission nursing assessment

c.Activity flow sheet

d.Graphic sheet

Definition
d.While one recording of vital signs should appear onthe admission nursing assessment (b), the best place tofind sequential recordings that show a pattern or trend isthe graphic sheet. The admission sheet (a) does notinclude vital sign documentation and neither does theactivity flow sheet (c).
Term

This method of documentation uses the categories data,action, and response (DAR) to facilitate charting.

a.Narrative notes

b.Focus charting

c.Charting by exception

d.Case management model

Definition
b.Focus charting is the only method of documentationthat uses the categories data, action, and response (DAR)to facilitate charting.
Term

A resident called to see a patient in the middle of thenight is leaving the unit and remembers that he forgot to write a new order for a pain medication you had requested for another patient. Tired and already beingpaged to another unit, he verbally tells you the order andasks you to document it on the physician’s order sheet.Your best response is:

a.“Thank you!”

b.Get a second nurse to listen to the order, and afterwriting the order on the physician order sheet, haveboth nurses sign.

c.“I am sorry but verbal orders can only be given in anemergency situation that prevents us from writingthem out. I’ll bring the chart and we can do thisquickly.”

d.Try calling another resident for the order or wait untilthe next shift.

Definition
c.In most agencies, the only circumstance in which anattending physician, nurse practitioner, or house officermay issue orders verbally is in a medical emergency,when the physician/nurse practitioner is present but findsit impossible, due to the emergency situation, to writethe order.
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