Exam 2 Flashcards
(126 cards)
1
Q
mutual recognition model
A
A regulatory model developed by the National Council of State Boards of Nursing which allows multistate licensure.
2
Q
standards of care
A
the skills and learning commonly possessed by a member of a profession
3
Q
implied contract
A
a contract that has not been explicitly agreed to by the parties but that the law nevertheless considers to exist
4
Q
Liability
A
the quality or state of being legally responsible for one’s obligations and action and to make financial restitution for wrongdoings
5
Q
respondeat superior
A
a legal term meaning “Let the Master Answer”- the employer assumes responsibility for the conduct of an employee and can also be held responsible for malpractice by the employee.
6
Q
collective bargaining
A
formalized decision making process between an employer and employees to negotiate wages and conditions of employment
7
Q
Informed Consent
A
A client’s agreement to accept a course of treatment or a procedure after receiving complete information, including the risks of treatment and facts relating to it, from the health care provider.
8
Q
Implied Consent
A
Consent that is assumed in an emergency when consent cannot be obtained from the client or a relative.
9
Q
Delegation
A
Transference of responsibility and authority for an activity to a competent individual
10
Q
Impaired Nurse
A
A nurse whose practice has deteriorated secondary to chemical abuse
11
Q
advance health care directives
A
a variety of legal and lay documents that allow persons to specify aspects of care they wish to receive should they become unable to make or communicate their preferences
12
Q
Health Care proxy
A
a legal statement that appoints a proxy to make medical decisions for the client in the event the client is unable to do so.
13
Q
Do Not Resuscite Orders
A
An expressed wish for a terminally ill patient for no resuscitation in the event of cardiac or respiratory event.
14
Q
Euthanasia
A
The act of painlessly putting to death persons suffering from incurable/distressing diseases.
15
Q
Tort
A
a civil wrong doing committed against a person or person’s property
16
Q
Misdemeanor
A
a legal offense usually punishable by a fine and/ or a short jail term sentence
17
Q
Malpractice
A
the negligent acts of persons engaged in professions or occupations in which highly technical or professional skills are employed
18
Q
Assault
A
An attempt or threat to touch another person unjustifiably.
19
Q
Battery
A
the willful or negligent touching of a person, which may or may not cause harm.
20
Q
Libel
A
Defamation by means of print, writing, or pictures
21
Q
Slander
A
Defamation by spoken word
22
Q
Civil Action
A
Legal actions deals with actions that are conflicts between two people. (for nurses this could be anything from equal protection to sexual harassment to abandonment)
23
Q
Criminal Action
A
Legal actions that deal with the relationships between individuals and society as a whole. Suchas, if a nurse intentionally kills a patient, society will bring them to trial.
24
Q
A primary care provider’s orders indicate that a surgical consent form needs to be signed. Since the nurse was not present when the primary care provider discussed the surgical procedure, which statement best illustrates the nurse fulfilling the client-advocate role?
A) “The doctor has asked that you sign this consent form”
B)”Do you have questions regarding the procedure?”
C)”What were you told about the procedure you are going to have?”
D) “Remember that you can change your mind and cancel the procedure”
A
Answer 3
25
Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube in the R nostril. The administrator of the hospital decided to settle the lawsuit because the nurse is guilty of......?
Battery
26
A nurse discovers that a primary care provider has prescribed a rather large dosage of a medication. Which is the appropriate action?
1) Administer the medication
2) Notify the physician
3) Call the pharmacist
4) Refuse to administer the medication
Notify the physician
27
A primary care provider prescribes one tablet, but the nurse accidentally administers two. After notifying the primary care provider, the nurse carefully monitors the client carefully for untoward effects of the medication. Of which there are none. Is the client going to be successful in suing the nurse for malpractice?
No, the client was not harmed
28
A nursing student is employed and working as an unlicensed assistive personnel on a busy surgical unit. The nurses know that the UAP is enrolled in a nursing program and will be graduating soon. A nurse asks the UAP if he has performed a urinary catheterizatation on clients while in the nursing program. The UAP responds "yes". The nurse asks him to help her out by doing this procedure on a postsurgical client. What should the UAP say?
No, I'm sorry, I cannot.
29
The nurse's spouse is undergoing surgery at the hospital where she works. What practice is most appropriate?
1) The nurse is an employee, so she is allowed to see the chart
2) The relationship with the client provides the nurse special privledges
3) Access to the chart will require a signed release form
4) The nurse can discuss with the surgeon that outcome of the surgery
3; the nurse has no special privileges just because she is an employee
30
Following a MVC, a nurse stops and renders care. Which of the following actions is or are most appropriate?
1) Knowing the Good Samaritan Act
2) The nurse is not held liable unless their is gross negligence
3) After assessing the situation, the nurse can leave to obtain help
4) The nurse should expect compensation for her work
5) The nurse can offer to help, but not insist or pressure
1,2,5
31
Which of the following could end in a malpractice suit?
1) Learning about a new piece of equipment
2) Forgetting to assess a patient
3) Does not follow up on a client's complaint
4) Asking a patient for their allergies
5) Asking the physician about an illegible order
2,3
32
When an ethical issue arises, one of the most important nursing responsibilities in managing client care situations is which of the following?
1) Be able to defend the morality of one's actions
2) Remain neutral and detached when making ethical decisions
3) Ensure that a team is responsible for deciding ethical questions
4) Follow the client and family's wishes exactly
1
33
Which of the following situations is most clearly a violation of the underlying principles associated with professional nursing ethics?
1) The hospital policy permits the use of internal fetal monitoring during labor. However, there is literature to support and refute the value of this practice.
2) When asked about the purpose of a medication, a nurse colleague responds, "Oh, I never look them up, I just give what is prescribed"
3) The nurses on the unit agree to sponsor a fund-raising event to support a labor strike proposed by fellow nurses at another facility
4) A client reports that he didn't quite tell the doctor the truth when asked if he was following his diet plan at home
2
34
Following a MVC, the parents of a pediatric pt. refuse to withdraw life support from their child who has NO brain function. Although the nurse believes the child should be allowed to die and organ donation should be considered, the nurse supports their decision. What moral principle is this nurse following?
Respect for Autonomy
35
Which of the following statements would be most helpful when a nurse is assisting clients in clarifying their values?
1) "The was NOT a good decision! Why would you think that would work?
2) "The most important thing is to follow the plan of care. Did you follow ALL your doctor's orders?"
3) "Some people might have made a different decision. Why did you make your decision in that way?
4) "If you had asked me earlier, I would have given you my exact opinion on what to do...Now how do you feel about your choice?
3
36
After recovering from her hip replacement, an elderly client wants to go home. The family wants the client to go to a nursing home. If the nurse were acting as a client advocate, the nurse would perform which of the following actions..
1) Inform the family that the client has a right to make their own decisions
2) Ask the primary care provider to discharge the patient home
3) Suggest the patient get a lawyer
4) Help the client and their family communicate their views to each other
4
37
Values, Moral Framework, and code of ethics influence the professional nurse's moral decisions in which of the following ways?
1) The nurse will provide direct client care that is consistent with the nurse's personal views
2) The nurse will seek to ensure that the nurse and client share the same values
3) The choice of moral framework determines what the client's outcome will be
4) The nurse is bound to act according to the nurses' code of ethics even if his or her values are different.
4
38
Validation
The act of “double checking” or verifying data to ensure it is accurate and factual
39
Subjective Data
*Symptoms*
*Covert Data*
Data that is apparent only to the person affected; can only be described or verified by that person
40
Review of Systems or “Screening examination”
a brief review of the essential functioning of various body parts or systems
41
Rapport
a relationship between two or more people of mutual trust and understanding
42
Open ended Questions
Questions that specify only the broad topic to be discussed an invite clients to discover and explore their thoughts and feelings about the topic
43
Objective Data
“Signs” “Overt Data” Information or data that is detectable by an observer or can be tested against an accepted standard; can be seen, heard, felt, or smelled
44
Non-Directive Interview
an interview using open-ended questions and empathetic responses to build rapport and learn client concerns
45
Neutral Question
A question that does not direct or pressure a client to answer in a certain way
46
Leading Questions
- a question that influences the client to give a particular answer
47
Interview
a planned communication, a conversation with purpose
48
Inferences
interpretations or conclusions made based on cues or observed data
49
Directive Interview
A highly structured interview that uses closed questions to elicit SPECIFIC information
50
Database
All information about a client, including nursing health history, physical assessment, physician’s history, physical examination, and lab/diagnostic test results.
51
Cues
Any piece of information or data that influences decisions
52
Closed Questions
Restrictive question requiring only one answer
53
Cephalocaudal
- Proceeding in the direction of from head to toe
54
Assessing
The process of collecting, organizing, validating, and recording data
55
Trial and Error
A problem solving method of trying different routes til one works
56
Socratic Thinking
a technique one can use to look beneath the surface, recognize and examine assumptions, search for inconsistencies, examine multiple points of view, and differentiate what one knows from what one merely believes
57
Problem Solving
Obtaining information that clarifies the nature of the problem and suggests possible solutions
58
Nursing Process
a systematic rational process of planning and providing nursing care
59
Intuition
- the understanding or learning of things without the conscious use of reasoning
60
Inductive Reasoning
making generalizations about specific data
61
Deductive Reasoning
making specific observations from a generalization
62
Decision Making
the process of establishing criteria by which alternative courses of action are developed and selected
63
Critical Thinking
a Cognitive process that includes creativity, problem solving, and decision making
64
Critical Analysis
A set of questions one can apply to a particular situation or idea to determine essential information and ideas and discard superfluous information and ideas
65
Creativity
thinking that results in the development of new ideas and products
66
Concept Mapping
- A visual tool in which ideas or data are enclosed in circles or boxes of some shape and relationships between these are indicated by connecting lines or arrows
67
A client with diarrhea also has a primary care provider's order for a daily bulk laxative. The nurse, not realizing that bulk laxatives can help solidify certain types of diarrhea, concludes "The Doctor does not know the client has diarrhea". This is an example of....
Inference
68
A client reports feeling hungry, but does not eat food when it is served. Using critical thinking skills, the nurse should perform which of the following?
1) Assess why the client is not eating
2) Continue to leave the food at the bedside until the client is hungry enough to eat
3) Notify the primary care provider that tube feeding is indicated
4) Believe the client is not hungry
1
69
One nurse expresses that the manager prepared the holiday work schedule unfairly. The manager states that it is the same schedule used in the past and other nurses have no problem with it. Which response indicates the nurse is displaying an attitude of critical thinking?
1) Accepting the preferences of the other nurses since there are several of them
2) Recognizing that the nurse must have reached a false conclusion
3) Considering going to a higher authority than the manager for an explanation
4) Continuing to query the manager until the nurse understands the explanation
4, the nurse should show perseverence
70
The client who is short of breath benefits from the head of the bed being elevated. Because this position can result in skin breakdown in the sacral area, the nurse decides to study the amount of sacral pressure occurring in other positions. This decision is an example of...
The research method
71
In the decision making process, the nurse sets and weights the criteria, examines alternatives, and performs which of the following before implementing the plan?
1) Re-examines the purpose for making the decision
2) Consults the client and family members to determine their view of the criteria
3) Identifies and considers various means for reaching the outcomes
4) Determines the logical course of action should intervening problems arise
4
72
The nurse is concerned about a client who begins to breathe very rapidly. Which action by the nurse reflects critical thinking?
1) Notify the primary care physician
2) Obtain VS and SPO2
3) Request a chest xray
4) Call the rapid response team
2
73
The nurse is teaching a client about wound care during a follow-up visit in the client's home. Which critical thinking attitude causes the nurse to reconsider the plan and supports evidence-based practice when the client states "I just don't know if I can afford these dressings.."
Integrity
74
When the nurse considers that a client is from a developing country and may have a postitive TB test due to a prior vaccination, which critical attitude and skill is the nurse practicing?
1) Creating environments that support critical thinking
2) Tolerating dissonance and ambiguity
3) Self- Assessment
4) Seeking Situations where good thinking is practice
1
75
A client in a cardiac rehabilitation program says to the nurse "I don't want to eat a low sodium diet for the rest of my life, that sounds horrible." What is the most appropriate response for the nurse?
1) "I will get a dietary consult to come talk to you before next week"
2) "What do you think is so difficult about following this diet?"
3) "At least you survived a heart attack and can work again"
4) "You may not need to follow this diet for as long as you think"
2
76
Which reasoning process describes the nurse's actions when the nurse evaluates possible solutions for care of an infected wound for optimal client outcomes?
Problem Solving
77
Which of the following behaviors is most representative of the nursing diagnosis phase of the nurse process?
1) Identifying major problems or needs
2) Organizing data in the client's family history
3) Establishing short term and long term goals
4) Administering an antibiotic
1
78
Which of the following behaviors would indicate that the nurse was utilizing assessment phase of the nursing process to provide nursing care?
1) Proposes hypotheses
2) Generates desired outcomes
3) Reviews results of lab tests
4) Documents care
3
79
Which of the following elements is best categorized as secondary subjective data?
1) The nurse measures a weight loss of 10 pounds since the last clinic visit
2) Spouse states the client has lost all appetite
3) The nurse palpates edema in the lower extremities
2
80
The nurse wishes to determine the client's feelings about a recent diagnosis. Which interview question is most likely to elicit this information?
1) What did the doctor tell you about your diagnosis?
2) Are you worried about how your diagnosis will affect your future
3) Tell me about your reaction to your recent diagnosis
4) How is your family responding to your diagnosis?
3
81
The use of conceptual or theoretical framework for collecting and organizing assessment data ensure which of the following?
1) Correlation of the data with other members of the health care team
2) Demonstration of cost effective care
3) Utilization of creativity and intuition in creating a plan of care
4) Collection of all necessary information for a thorough appraisal
4
82
Which of the following is the purpose of assessing?
1) Establish a database of client responses to his or her health status
2) Identify clients strengths and problems
3) Develop an individualized plan of care
4) Implement care, prevent illness, promote wellness
1
83
In validating activity of the assessing phase of the nursing process, the nurse performs which of the following?
1) Collects subjective data
2) Applies a framework of knowledge to the collected data
3) Confirms data is complete and accurate
4) Records data in the client record
3
84
A major characteristic of the nursing process is which of the following?
1) A focus on the client needs
2) Its static nature
3) An emphasis on physiology and illness
4) Its exclusive use by and with nurses
1
85
Which of the following would be true regarding use of the observing method of data collection?
1) When observing, the nurse uses only the visual sense
2) Observing is done only when no other nursing interventions are being performed at the same time
3) Data should be gathered as it occurs, rather than in any particular order
4) Observed data should be interpreted in relation to other sources of collected data
4
86
Which of the following represent effective planning of the interview setting?
1) Keep the lights dimmed as to not stress the client's eyes
2) Ensure that no one can overhear the interview conversation
3) Stand near the client's head while they are sitting in a bed or chair
4) Keep a 3 foot perimeter from the client
5) Use a standard form to be sure all relevant data is covered in the interview
2,4,5
87
Defining Characteristic
client's signs and symptoms that must be present to validate a nursing diagnosis
88
Dependent Function
Physician prescribed therapies and treatments which a nurse must carry out
89
Diagnosis
a statement or conclusion regarding the nature of a phenomenon
90
Diagnostic labels
Title used to write a nursing diagnosis; NANDA. A taxonomy of terms used to label the primary problem or set of problems.
91
Etiology
The causal relationship between a problem and it's related or risk factors
92
Heath promotion diagnosis
Description of a patient's readiness to implement health improving behaviors
93
Independent function
areas of health care unique to nursing, separate and distinct from medical management
94
Norm
An ideal or fixed standard, an expected standard of behavior of a group
95
Nursing Diagnosis
a diagnosis given by a nurse. Must be in the domain of health that nurses are educated and licensed to treat
96
PES format
P= Problem, E=Etiology, S= Signs and symptoms; the three essential components of the nursing diagnosis statement
97
Qualfiers
Words that have been added to NANDA labels to give additional meaning to the diagnostic statement: Deficient, Impaired, Decreased, Ineffective, Compromised
98
Risk factors
Factors that cause a client to become vulnerable to developing a health problem
99
Risk nursing diagnosis
A clinical judgment that a problem does not exist, but has a set of risk factors that indicates a problem is likely to develop unless there is an intervention
100
Standard
a generally accepted role, model, pattern, or measure
101
Syndrome diagnosis
A diagnosis that is associated with a cluster of other diagnoses
102
Taxonomy
A classification system or set of categories that is arranged based on a single set of principles
103
Wellness Diagnosis
NANDA- describes human responses to levels of wellness in an individual, family, or community that have a readiness for enhancement
104
After being admitted directly to the surgery unit, a 75 year old client who had elective surgery to replace an arthritic hip was discharged from the recovery unit. The client has been placed on the orthopedic floor for several hours. Which type of planning will be LEAST useful during the first shift on the orthopedic floor?
1) Initial
2) Ongoing
3) Discharge
4) Strategic
4
105
The nurse is conducting the diagnosing phase(nursing phase) of the nursing process for a client with a seizure disorder. Which step exists between data analysis and formulating the diagnostic statement?
1) Assess the client's needs
2) Delineate the client's problems and strengths
3) Determine which interventions are most likely to succeed
4) Estimate the cost of several approaches
2
106
In the diagnostic statement "Excess Fluid Volume- related to decreased venous return as manifested by lower extremity edema"
Which part is the etiology?
Decreased venous return
107
Which of the following diagnoses contains the proper components:
1) Risk for Caregiver role strain related to unpredictable illness course
2) Risk for Falls related to tendency to collapse when having difficulty breathing
3) Impaired communication related to a stroke
4) Sleep Deprivation secondary to fatigue and a noisy environment
1; problem and cause
108
One of the primary advantages of using a 3 part diagnostic statement such as the PES format includes which of the following:
1) Decreases the cost of healthcare
2) Improves communication between nurse and client
3) Helps the nurse to focus and health and wellness elements
4) Standardizes organization of the client's data
4
109
A collaborative problem is indicated instead of a nursing or medical diagnosis if:
1) Both the medical and nursing interventions are required to treat the problem
2) When independent nursing actions can be utilized to treat the problem
3) In cases where nursing interventions are the primary actions required to treat the problem
4) When no medical diagnosis can be determined
1
110
In the case in which a client is vulnerable to developing a health problem the nurse chooses which type of nursing diagnosis status:
A risk nursing diagnosis
111
Which of the following is true regarding the state of the science in regards to nursing diagnosis?
1) The original taxonomy has proven to be adequate in scope
2) The organizing framework of the taxonomy is based on the work of Florence Nightengale
3) More research is needed to validate and refine the diagnostic labels
4) New diagnostic labels are approved by means of a vote of registered nurses
3
112
Which of the following would indicate a significant cue when comparing data to standards? (Select all the apply)
1) The client has moved partway toward a set goal
2) The client's vision is within normal range only when wearing glasses
3) A child is able to control bladder and bowels at age 18 months
4) a woman widowed recently states "she is unable to cry
5) a 16 year old patient reports spending 5 hours doing home work 5 nights per week
1, 4, 5
113
Standardized Care Plan
a formal plan that specifies the nursing care for a group of clients with common needs
114
Rationale
The scientific reasoning to select a specific reason
115
Protocols
Predetermined; preprinted plans specifiying the procedure for a specific situation
116
Procedures
Steps used in carrying out policies and activities
117
Priority Setting
The process of establishing a preferential order for nursing strategies
118
Policies
Rules developed to govern the handling of frequently occurring situations
119
The client with a fractured pelvis requests that his family members be allowed to stay overnight in the hospital room. Before determining whether or not this request can be honored, the nurse should consult which of the following?
Policy and Procedures
120
The nurse assesses a postoperative client with an ABD wound and find the client is drowsy when not aroused. The client's pain is a "2" on a 1-10 scale, VS are normal. Skin is very dry. Extremities are warm. The client states that they feel nauseous and do not want oral fluids. No BM is 2 days. His dressing is dry with drains intact. Which element is most likely to be considered high priority for a change in the current plan?
Nauseous
121
The nurse selects the nursing dx. of Risk for impaired skin integrity related to immobility, dry skin, and surgical incision. Which of the following represents a properly stated outcome/goal?
The client will:
1) Turn in bed q2h
2)Report the importance of applying lotion to skin daily
3)Have intact skin during hospitalization
4)Use a pressure reducing mattress
3
122
The care plan includes a nursing intervention "4/2/11 Measure client's fluid intake and output. F. Jenkins, RN" What element of a proper nursing intervention has been omitted?
Time
123
The nurse recognizes which of the following as a benefit of using a standardized care plan?
1) No individualization is needed
2) The nurse chooses from a list of interventions
3) They are much shorter than nurse-authored care plans
4) They have been approved by accrediting agences
2
124
Which of the following is likely to occur if the goal statement is poorly written?
1) There is no standard against which to compare outcomes
2) The nursing diagnosis cannot be prioritized
3) Only dependent nursing interventions can be used
4) It is difficult to determine which nursing intervention can be delegated
1
125
When properly written NOC outcomes and indicators
1) Do not require customization
2) Address several nursing diagnoses
3) Are broad statements of desired end points
4) Reflect both the nurse's and clients values
4
126
Which of the following principles does the nurse use in selecting interventions for the care plan?
1) Actions should address the etiology of the nursing diagnosis
2) Always select independent interventions when possible
3) There is one best intervention for each goal/outcome
4) Interventions should be "doing" not just "monitoring
1
