NUR 108 final 2 Questions and Answers,100% CORRECT

NUR108 final 2 Questions and Answers Which statement reflects the ethical principle of justice? Patients should be able to go to the physician of their choice. Patients should be treated equally regardless of socioec ...

NUR108 final 2 Questions and Answers Which statement reflects the ethical principle of justice? Patients should be able to go to the physician of their choice. Patients should be treated equally regardless of socioeconomic status. submitted If a health care provider agrees to care for a patient, there is an obligation to follow through. Competent care is a patient’s right and a provider’s obligation. Which ethical principle is implicit in the statement “Provision of safe, competent care without patient harm is a healthcare provider’s duty.”? Nonmaleficence submitted Justice Veracity Autonomy Which statement made during a meeting of a hospital’s ethics committee is based on the ethical principle of autonomy? Costly treatment measures should not be prohibited for the elderly based on age. This treatment is not appropriate for this patient because the danger of destroying the liver is greater than any potential beneficial effect. The nurse agreed to be present when the patient talked to family about surgical treatment, however the nurse did not show up. Patients have a right to refuse pain medication even when they admit to having severe pain. submitted Which of the following is a contributing factor to the higher patient mortality rates in the United States as compared to other developed countries? Diversity of the population. Limited access to healthcare. submitted Population density. Aging of the population. Which step in the ethical decision-making process does the RN explore personal bias about an ethical issue? Assessment submitted Evaluation Diagnosis Planning An RN states, “I feel emotionally drained and physically sick after caring for some patients who receive aggressive treatments. It seems like we are only prolonging their dying process.” What is this RN experiencing? Cultural shock Disillusionment in nursing Work overload Moral distress submitted Which ethical principle is the nurse violating when the nurse tells a crying child, “If you don’t swallow this pill, I am going to give you a shot into your leg.”? Justice Obligation Fidelity Nonmaleficence submitted The RN is teaching the student nurse about the ANA Standards of Ethical Practice. Which statement by the student nurse indicates additional teaching is necessary regarding patient protection and impaired practice? “Assistance is available for impaired nurses from professional associations.” “Impaired nurses may return to practice after recovery.” “Nurses who report impaired colleagues risk retaliation from the institution.” submitted “Report all concerns regarding an impaired co-worker to the nursing supervisor.” A terminally ill patient who is considering withdrawal of treatment asks the RN if the family should be told. What is the next step in ethical decision making for the RN? Review the possible options of disclosure. submitted Consult with a member of the ethics committee. Identify a physician who can write the necessary prescriptions. Discuss the patient’s feelings and concerns. The RN who speaks up when a health care worker does not perform hand hygiene is upholding which ethical principle? Veracity Autonomy Justice Nonmaleficince submitted A student nurse asks an RN “What strategies are useful when faced with an ethical dilemma in professional practice?” How does the RN respond? Select all that apply. “I defer to the healthcare provider to make the correct decision.” “I focus on myself and what I would I do if faced with the issue.” “I use the nursing process to organize my thought process.” “I consult the ethics committee when the problem is complex.” “I use the Nursing Code of Ethics for guidance.” Submitted A patient with end stage heart disease is seeking a heart transplant. What ethical principle supports the eligibility criteria that reviews the patient’s history of adherence to the medical treatment plan? Veracity Distributive justice submitted Autonomy Beneficence A patient refused to receive blood products based on religious beliefs. The patient had unexpected blood loss during surgery. Which action by the healthcare team is consistent with patient autonomy? Convince the family that administering blood is the right thing to do. Give blood products in the operating room to stabilize the patient. Aggressively treat the patient with therapies that exclude blood products. submitted Encourage the family to agree to a do not resuscitate order. A patient who is considering enrolling in a clinical research trial asks the RN “What would you do?” How does the RN respond in an ethical manner? “I would agree to be enrolled because the study will also help other people.” “The study offers you a hope of a cure, it would be worth a try.” “I prefer to be treated with the medications that other people have used.” “It is a difficult decision, we will support you in whatever you chose.” submitted Which RN actions are supported by the 2015 ANA Code of Ethics? Select all that apply. Participate in scientific inquiry to advance nursing practice. Collaborate with others to promote health initiatives. Accept accountability for delegation of nursing activities. Advocate for patient rights. Address patient needs as the priority before personal duties. Submitted A teenager with a chronic disease disagrees with their parents regarding aggressive or palliative care treatment options. Which is the best response by the RN? “In my experience, aggressive care has the best results.” “The ethics committee can assist with the decision-making process.” submitted “Your parents are ultimately responsible for making this decision.” “It is best to rely on the decision by your healthcare provider.” A patient with no health care directives is admitted to the hospital with a devastating stroke. The family asks the RN about options regarding resuscitation efforts. What is the RN’s best initial response? “Gather your family to make the best decision.” “What do you think the patient would want done?” “Do you want to discuss all possible outcomes?” “It is too early to make this decision.” unanswered The RN is returning to work after placing a family member in Hospice care. Which response should the RN use when a terminally ill client asks, “Should I sign a do not resuscitate order?” “I would choose not to be resuscitated, too.” “If you would like to seek spiritual counseling, I can call pastoral care.” “I just put my mother in Hospice care with a do not resuscitate order.” “This is a difficult situation; what are your views on end of life care?” submitted A patient receiving home care is prescribed an analgesic medication that is twice the dose recommended by the manufacturer. Before administering the initial dose of the medication, what is the best response by the RN? Inform the patient the dose might be lethal and cannot be administered. Use nursing judgment and give half of the dose prescribed by the health care provider. Contact the prescribing provider for clarification of the dose. submitted Administer the dose as prescribed because it has been dispensed by a pharmacist. Which element of health care reform provides the greatest opportunity to reduce health care costs? Electronic health record Organization accreditation Experience rating systems Insurance recission unanswered Which statement by the RN demonstrates an understanding of the benefit of The Joint Commission hospital accreditation? “Accreditation provides a competitive edge in the healthcare marketplace.” “Accreditation validates efforts on improving the workplace environment.” submitted “Accreditation signifies the organization will be the best choice for clients to receive care.” “Accreditation certifies increased staffing levels on the nursing units.” What information does the RN include when explaining to a nursing student the advantages of being employed at a magnet hospital? The preferred leadership style in a magnet hospital is authoritative. Magnet hospitals undergo an external review to document standards of nursing excellence. submitted Magnet hospitals have better benefit packages than non-magnet hospitals. Non-magnet hospitals always have low patient satisfaction scores. Which collaborative has the mission to work with federal and state agencies to strengthen policies and practices with the outcome of making people healthier? Quality and Safety Education for Nurses American Association of Retired People Healthy People 2020 submitted The Institute of Medicine A patient awaiting surgery states “I chose the hospital for my surgery because it received high ratings on the internet.” What is the most appropriate response by the RN? “Tell me about the internet source you used for decision making.” submitted “Social media sites are a good source of information about local hospitals.” “Make sure you always choose a recently updated website for this information.” “The internet is what I use to check hospital ratings.” Which nurse would best assist a patient diagnosed with breast cancer requiring radiation and chemotherapy? Nurse navigator submitted Forensic nurse Client safety nurse Nurse researcher The hospital is planning to implement a new bar code system for medication administration. Which statement describes the role of the RN to decrease medical errors? “Training sessions should be optional for experienced nurses.” “A bar code system will eliminate the need for the RN to review medications.” “I will learn to bypass the system during patient care emergencies.” “I will ask to participate on the committee for bar code system design.” submitted The RN is caring for an older adult patient admitted with frequent falls at home. Which initial strategy is most effective to improve patient outcomes? Coordination of care with an interdisciplinary team. submitted Frequent hospitalizations help to manage illness effectively. Maintain bedrest with close supervision. Prepare for transfer to skilled nursing facility. The RN is participating in a community forum on Health Care reform and is asked to comment on the projected impact of the Affordable Care Act for the profession of nursing. Which elements would the RN include in the response? Select all that apply. Greater need for RNs to care for an increased number of persons seeking health care. Increased use of Advanced Practice Nurses in the acute care and primary care settings. Heightened demand for RNs in specialty fields such as informatics and case management. Bolster the power of the American Nurses Association as a result of requirement for employment. Development and implementation of new nursing roles. submitted A student nurse asks the RN “Is there anything special to consider when teaching prevention strategies to the older adult?” What is the best response by the RN? “Older adults are less likely to be interested in learning new things.” “The chronically ill older adult may have limitations that require special teaching methods.” submitted “Older adults tend not to be motivated and don’t make lifestyle changes.” “The nursing educational plan is the same for all adults regardless of age.” An older adult patient with a newly diagnosed illness tells the RN, “It looks like I need to make peace with God.” What is the RN’s best initial response? “The clergy is much better trained to address your concerns.” “Do you want me to pray with you?” “I can contact your family and friends who can support you during this time.” “Are you distressed about your condition?” submitted What is an advantage of the telehealth technology? Minimizes liability issues for the caregiver. Requires minimal preparation for health providers and patients. Allows healthcare providers to treat patients from distant sites. submitted Private health care insurance fully covers costs. What is a benefit of the Affordable Care Act? Increases administrative costs for insurance companies. Decreases Medicaid payments to primary care physicians. Financially rewards technology driven acute hospital based services. Eliminates co-pays for preventative services. submitted Which action by a health care worker demonstrates a potential violation of patient privacy information when using a computerized medical record? Using institutional communication devices for work related issues. Using a privacy filter on computers that can be seen by others. Posting a personal computer password in the nursing station. submitted Logging out of the computer screen when finished with documentation. A patient requires a transfer to a long-term nursing care facility after an extended acute care hospitalization. Which member of the health care team would best assist the patient and family with the process? Nurse manager Nurse care coordinator submitted Bedside nurse Client safety nurse What does the RN anticipate as a societal health care need in the future?. Expansion of acute care capacity. Growth in the aging population. submitted Increase use of task orientated nurses. Paternalistic approach to the plan of care. Which statement demonstrates the purpose of The Joint Commission (TJC)? Develops program outcomes for quality nursing education. Creates a national agenda to eliminate health disparities. Identifies elements to attract and retain professional nurses. Endorses an organization that provides high-quality service. submitted Which statement by the RN demonstrates cultural sensitivity? “I ask each patient about practices to promote wellness.” submitted “I learned to speak another language.” “I am familiar with many different cultures.” “I treat people as I would want to be treated.” The RN is providing care for a hospitalized patient who states, “I will never be able to manage my medications and appointments with all of these doctors. How will I ever do this?” Which nurse role should the RN collaborate with to help the patient? Nurse navigator submitted Forensic psychiatric nurse Nurse coder Nurse safety officer Which task can the RN delegate to an Assistive Personnel (AP)? Showing a patient how to empty a wound drainage device. Checking a patient’s ankles for swelling after sitting in a chair. Obtaining a blood pressure on a patient experiencing dizziness. Measuring oral intake and output for a geriatric patient. submitted A student nurse asks the RN about the legal authority to delegate tasks. Which statement describes why RNs have the legal right to delegate? Employment by an institution approved for operation by the state provides legal authority to delegate. RNs are licensed and governed by a statutory practice act which allows legal delegation. Completion of a specialized program of professional study allows the RN to legally delegate. American Nurses’ Association Standards of Practice allow legal delegation by the RN. Submitted An assistive personnel (AP) says “I am not sure I calculated the intake and output correctly, but I know the nurse is always responsible.” Which is an appropriate response by the RN to the AP? “You are working under the RN’s license when you accept responsibility for this task.” “The RN does not need to supervise tasks that are within the AP job description.” submitted "APs cannot record intake and output, you should not have done those tasks.” “When you agree to perform a task, you are responsible for your actions in carrying it out.” An LPN is assigned to care for a patient who suddenly develops acute respiratory distress. What is the most appropriate action by the charge RN? Assign an RN to the LPN’s patient and reassign the LPN. submitted Assign the LPN’s other patients to different nurses within the team. Assign an assistive personnel (AP) to help the LPN with patient care. Monitor the LPNs ability to handle patient needs and reassign only if needed. A nurse manager is fostering assertive behavior in the nursing staff. What is the best response by the nurse manager to an RN who states that an assistive personnel (AP) consistently leaves patient units untidy? “Discuss the issue with the AP and see if the two of you can come up with a solution.” submitted “I will speak to the AP but I need you to put the problem in writing.” “Please plan to bring up environmental clutter concerns at the next unit meeting.” "Plan to meet with me and the AP; I will get back to you with the details by the end of the day.” Which task is appropriate for the RN to delegate to an LPN/LVN? Provide stoma care for a patient with an established colostomy. submitted Monitor a newly admitted patient with acute heart failure. Teach a patient’s spouse how to cleanse and dress a wound on the posterior thigh. Assess the function of a newly inserted intestinal tube. Which patient would be most appropriate for the RN to assign to the LPN/LVN? A patient who had a stroke and is awaiting transfer to a subacute facility. submitted A patient with newly diagnosed diabetes mellitus who needs a home care referral. A newly admitted patient with pneumonia who needs a care plan developed. A patient with a hip fracture who requires a blood transfusion. The homecare RN is coordinating care for a chronically ill patient. Which task can be delegated to the assistive personnel (AP)? Teach family to administer pain medication orally. Assist with bathing during every visit. submitted Auscultate lung sounds and report abnormal findings to the RN. Evaluate gait and the potential need for a walker. The RN delegates oral care for an unconscious client to the assistive personnel (AP) who floated to the unit. The RN should intervene when observing the AP perform which actions? Select all that apply. Turning the client’s head to the side. Placing an emesis basin under the client’s mouth. Using a gloved finger to open the client’s mouth. Positioning the client flat with knees flexed. Placing 120 ml of mouthwash in the client’s mouth. submitted The RN is planning care for a group of clients and has an LPN/LVN and an assistive personnel (AP) on the team. Which client is most appropriate for the RN to delegate care for to the LPN/LVN? A client with stable heart failure who will be discharged in the afternoon. submitted A client who had a heart attack four days ago and is short of breath on exertion. A client scheduled for an EKG and Chest X-ray. A client with pneumonia who is weak and needs assistance with bathing. A nursing student asks the RN preceptor a question about their legal responsibility in delegation. Which response by the RN preceptor most accurately answers this question? “You must know the agency’s definition of specific roles and job description of the delegatee”. submitted “You must know where the delegatee received their education”. “You must know how clients have evaluated the delegatee’s performance in the past”. “You must know the actual time it takes to perform a task before you can delegate it”. The RN is assigned to a client with diabetes. Which nursing actions can the RN delegate to the assistive personnel (AP)? Select all that apply. Assessing for signs and symptoms of dehydration. Recording intake and output every four hours. Obtaining a blood glucose if the client complains of being dizzy. Reinforcing client education about diet. Measuring vital signs every 4 hours. submitted Which statement by the RN demonstrates an external barrier to effective delegation? “I am uncomfortable asking the AP for help for fear they won’t like me”. “I don’t know what care the LPN/LVNs can do for my clients”. submitted “I am taking care of too many clients because we are short staffed”. “I am not confident the LPN/LVN will do a good job with the client’s care”. The RN delegated care of a client to the LPN/LVN. The client’s condition has now changed. The client is septic and unstable. What is the most appropriate RN action in this situation? Tell the LPN/LVN to increase vital signs to every 30 minutes and report them to you promptly. Tell the AP to assist the LPN/LVN with vital signs and ambulating the client to the bathroom. Tell the LPN/LVN you will assume responsibility for the client and assign them to a stable client. submitted Tell the LPN/ LVN to call the provider with client lab results. The AP caring for a client with a pacemaker reports to the nurse that the client was short of breath, so they increased the oxygen via nasal cannula “to help you out”. What is the best response by the RN to the AP? “Please tell me how high you set the flow rate and if you checked the pulse oximetry after the change.” “Thank you, I appreciate your help. I need to get this discharge done quickly”. “You should never change the client’s oxygen without my approval first.” submitted “Thank you, I appreciate your help but I am responsible for the decision to increase the oxygen.” The RN is working with an LPN/LVN who will be administering medications to their clients. A client on a Heparin intravenous infusion needs to have the infusion rate increased. What is the best action for the RN to take in this situation? Show the LPN/LVN how to increase the infusion rate so they can do it next time. Instruct the LPN/LVN on what time and how much to increase the infusion rate. Increase the infusion rate and inform the LPN/LVN of the change and to observe any increased bleeding. submitted Have the LPN/LVN take over your assessment of a client’s wound while you change the infusion rate. Which sequence of activities best describes the RN’s use of professional judgment when delegating care? Determine scope of practice of personnel, determine client needs, determine if the task requires nursing judgment Determine degree of supervision needed, determine competence of personnel, determine laws and rule supporting delegation. submitted Determine client needs, determine laws and rule supporting delegation, determine the job responsibilities of personnel. Determine if the task requires nursing judgment, determine scope of practice of personnel, determine predictability of task results. Which client situation demonstrates the RN’s responsibility for evaluating safe client outcomes? A client being discharged who is cared for by another RN. A client being admitted by the advanced practice nurse. A client with a wound infection cared for by an LPN/LVN. A client with acute renal failure cared for by another RN. submitted The nurse manager solicits support from the nursing staff when preparing the unit budget. Which activities by the nursing staff assist with positive management of resources? Select all that apply. Prevent interruptions when administering medications. Promote self-care activities for all team members. Delegate tasks to the appropriate health care worker. Use “down time” to have social conversations with peers. Keep extra supplies in the patient’s room to save time. submitted Which statement by the RN reflects an aggressive approach to conflict resolution? “We need to find a solution to this problem so that patient care doesn’t suffer.” submitted “You need to follow my instructions exactly as I explained to you.” “I want to understand your position but it is still not clear to me.” “It is not what I want, it is what the patient needs.” Which is an example of assertive communication by the RN during the interdisciplinary team patient care meeting? “The intervention you are suggesting is wrong for this patient.” “We are here to seek ways to improve care.” submitted “The pharmacist needs to be reprimanded for delivering the meds late.” “The patient fell because he did not ask for help.” The nurse manager asks clinic employees to participate in a nurse-led committee. The goal of the committee is to design and implement a plan addressing patient dissatisfaction with long wait times. What type of leadership is the nurse manager displaying? Authoritarian Laissez-faire Democratic submitted Autocratic During a unit meeting, the nursing staff identifies a concern with the shift report process. The nurse manager says, “Go ahead and do something else.” Which style of leadership is the nurse manager using? Transformational Laissez-faire submitted Authoritarian Democratic The RN sees an assistive personnel enter a patient’s room without wearing the necessary personal protective equipment (PPE) for transmission-based precautions. Which is the best response by the RN? “Your behavior is why we have so many infections on this nursing unit.” “I wear all the PPE if I am not touching the patient.” “Appropriate PPE is essential to reduce the risk of health care infections.” submitted “Not wearing the correct PPE is bad nursing practice.” The RN is meeting with a staff member to discuss recurrent late arrival for scheduled shifts. The staff member is highly animated and begins to explain multiple reasons for lateness. Which is the RN’s best response? “This behavior will not avoid the conversation. You need to be quiet and listen.” “You seem very upset. If you are on time in the future we can forget about this.” “You are lucky I am talking to you. Recurring lateness is grounds for dismissal.” “Sit down and take a deep breath. We need to resolve this issue.” submitted The RN is participating in multidisciplinary rounds. Which outcomes address conflict management in this collaborative environment? Select all that apply. Opportunity to understand another’s point of view is provided. Support and respect for the team is demonstrated. Teamwork and harmony is enhanced. Minimal time and resources are expanded. A win/win agreement is potentially produced. submitted Which factors influence the number of RNs assigned to a patient care unit? Select all that apply. The type of management structure. Acuity of the patients. Availability of ancillary support. The physical layout of the unit. The access to resources by staff. Submitted Which is the primary reason that incivility among healthcare professionals presents a threat to patients? Incivility begins with impoliteness and leads to violence. Incivility is associated with an increase in medical errors. submitted Incivility creates additional stress in the health care environment. Incivility is linked to lower staff productivity. The RN is assembling a health care team to help coordinate care for a homeless adult who has a leg ulcer. Which team member must the RN include? Client safety nurse Occupational therapist Social worker submitted Physical therapist A novice nurse asks, “Why is the experienced RN assigned to admit the child with a high fever?” What is the most appropriate response by the RN? “The experienced RN likes to be challenged and take care of very sick children.” “The child and family requested the experienced RN to be their nurse.” “The experienced RN has fewer assignment duties and can admit this child.” “The child requires ongoing assessment, intervention, and evaluation.” submitted Which statement made by the charge RN at the end of a shift demonstrates transformational leadership behavior? “We all did a good job today taking care of difficult patients.” “If we were more organized, we could have gotten more work done.” “Everyone survived today thanks to hard work and good luck.” submitted “See you all tomorrow for another challenging day at work.” An RN co-worker complains about assignments when receiving report every day. What is the most appropriate response by the RN? Ignore the co-worker’s comments. Suggest the co-worker take a personal day. Change the co-worker’s assignment. Ask the co-worker to accept the assignment. submitted Which RN actions support the nursing leadership team in maintaining an appropriate operational budget? Select all that apply. Communicate effectively with the interdisciplinary team. Delegate tasks within the nursing team appropriately. Prevent health-care associated infections. Save time by putting aside extra supplies and equipment. Provide patient/family education based on patient needs. submitted Which demonstrates a successful RN leadership behavior? Create healthy competition between staff members. Make decisions for the team. Recognize the contributions of the team. submitted Maintain control over all aspects of the team. Which leadership characteristic exemplifies a laissez-faire style? Allows staff to make own decisions. submitted Promotes downward communication. Seeks input from others for judgments. Maintains control over the group. Which RN is appropriately demonstrating an autocratic leadership style? Nurse faculty member shares the reading list before the semester starts. Nurse manger provides multiple options before making a decision. Charge nurse delegates roles during a lockdown. submitted Staff nurse participating in unit self-scheduling. Which RN activity demonstrates problem solving as a conflict resolution strategy for supervising personnel? Using the nursing process to address staffing issues Settling on an agreement that is acceptable to all parties submitted Postponing discussions until the right time is available Reflecting on past experiences to understand emotions Which member of the healthcare team should the RN work closely with to assist a client in regaining the ability to dress and self-feed? Chiropractor Occupational therapist submitted Dietician Physician assistant Which steps do RNs use as part of the conflict resolution process? Select all that apply. Analyze data Delegate tasks Set goals Identify the problem Develop a plan of action submitted Which RN actions demonstrate transformational leadership theory? Adjusts the leadership style based on the issue at hand. Emphasizes outcomes; exercises authority; recognizes diverse communities. Responds to the situation; charms the followers; motivates workers. Creates a vision; recognizes existence of multiple intangibles when people interact. submitted Which leadership style is most appropriate to use when inviting input from the staff to create a work schedule to cover the winter holidays? Laissez-Faire Autocratic Permissive Democratic submitted Which RN action has the most impact on creating a healthy work environment? Sleeping more hours at night Recognizing peer differences submitted Mentoring a colleague Leaving a toxic job environment