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Flashcards in NSG Role Deck (13):
1

The nurse, who is participating in a community health fair, assesses the health status of attendees. When would the nurse conduct a mental status examination?

A: As part of every health assessment

B: The individual displays restlessness

C: The individual reports memory loss

D: There are obvious signs of depression

As part of every assessment. Need to establish baseline

2

he nurse manager informs the nursing staff that the clinical nurse specialist will be conducting a research study on staff attitudes toward client care, and all staff are invited to participate in the study if they wish. This affirms which ethical principle?

A: Anonymity

B: Beneficence

C: Autonomy

D: Justice

C: Autonomy

Individuals must be free to make independent decisions about participation in research without coercion from others. Anonymity means the person’s identity is not revealed. Beneficence is the state or quality of being kind, charitable, beneficial or a charitable act.

3

The nurse, who is located in a large urban area, uses telecommunications to provide health care and education to clients in remote locations. What is the best reason for using telehealth?

A: Reduces health care costs

B: Empowers pts to take a greater interest in their illness

C: Standardizes electronic data sharing of health info

D: Removes time and distance barriers from the delivery of care

D: Removes time and distance barriers from the delivery of care

Telehealth is the use of technology to deliver health care, health information, or health education at a distance. People in rural areas or homebound clients can communicate with providers via telephone, email or video consultation, thereby removing the barriers of time and distance for access to care. Although increased access to information and collaboration between the client and provider can be empowering, this is not the primary reason for using telecommunications/telehealth.

4

During a situation of pain management, which statement is a priority to consider for the ethical guidance of a nurse?

A: Pt have the right to have their pain relieved

B: The pt's self-report is the most important consideration

C: Cultural sensitivity is fundamental to pain manangement

D: NSGs should not prejudge a pt's pain using their own values

B: The pt's self-report is the most important consideration


Pain is a complex phenomenon that is perceived differently by each individual. Pain is whatever the client says it is. The other statements are correct but not the most important consideration.

5

The nurse is caring for a client in a violent relationship. The nurse should understand that immediately after an acute battering incident, the batterer may respond to the partner’s injuries by taking which action?

A: Seek medical help for the victim's wounds

B: Contact a close friend & ask for help w/the incident

C: Be very remorseful & assist the victim to receive medical care

D: minimize the episode w/an underestimation of the victim's injuries

D: minimize the episode w/an underestimation of the victim's injuries


Many batterers lack an understanding of the effects of their behavior on the person who was battered. Batterers use excessive minimization and denial of the situation and their behaviors or intent.

6

Which statement describes the advantage of using a decision grid to make decisions?

A: It allows the ata to be graphed for easy interpretation

B: Is is both a visual and a quantitative method of decision making

C: It is the only truly objective way to make a decision in a group

D: It is the fastest way for a group decision making

B: Is is both a visual and a quantitative method of decision making


A decision grid allows the group to visually examine alternatives and evaluate them quantitatively with weighting

7

The nurse is caring for a client in a home setting. Which action is most likely to ensure the safety of the nurse during a home visit?

A: Carry a cell phone, pager and/or hand-held alarm for emergencies

B: Remain alert at all times and leave if cues suggest that the home is not safe

C: Observe no evidence of weapons in the home during the visit

D: Review the client's record for any previous entries about violence prior to the visit

B: Remain alert at all times

No person or equipment can guarantee nurses' safety, although the risk of violence can be minimized. Before making initial visits, review referral information carefully and have a plan to communicate with agency staff. Schedule appointments with clients. When driving into an area for the first time, note potential hazards and sources of assistance. Become acquainted with neighbors. Be alert and confident while parking the car, walking to the client's door, making the visit, walking back to the car, and driving away. LISTEN to clients. If they tell you to leave, do so.

8

A nurse who cares for clients undergoing treatment for cancer might expect clients diagnosed with cancer to make the following statements.
Based on an understanding of the stages of the grieving process, place the statements in the correct order.

A: If I eat a more balanced diet, I can live longer

B: I think the tests got mixed up

C: I will just go on with my life

D: I am so mad at everyone for always reminding me that I have it

E: I don't know where to go or what to do

B, D, A, E, C

The phases of loss or the grief process according to Dr. Kubler-Ross are: denial, anger, negotiation, depression and acceptance.

9

A nurse is assessing a client's home in preparation for discharge. Which of these observations should be given priority consideration?

A: Proximity to emergency services

B: Financial status overall

C: Family's understanding of pt's need

D: Location of bathrooms

C: Family's understanding of pt's needs

The degree and depth of the family’s understanding of the needs for the client is a priority. In addition, functional communication patterns between family members are fundamental to meeting the needs of the client and family.

10

During the change-of-shift report, the assigned nurse notes a client of the Catholic religion is scheduled to be admitted for the delivery of a ninth child. Which comment made by a nurse indicates an attitude of prejudice?

A: "I think she needs to go to the city hospital."

B: "I guess she doesn’t understand how to use birth control."

C: "All those people indulge in large families!"

D: "I wonder who is paying for this trip to the hospital?"

C: ALL those people indulge in large families

Prejudice is a hostile attitude toward individuals simply because they belong to a particular group presumed to have objectionable qualities. Prejudice refers to preconceived ideas, beliefs, or opinions about an individual, group or culture that limit a full and accurate understanding of the individual, culture, gender, race, event or situation.

11

The clinic nurse is counseling a postpartum client who has a substance-abuse problem and is at risk for continued cocaine use. In order to provide continuity of care, which nursing diagnosis should be a priority?

A: Altered parenting
B: Social isolation
C: Ineffective coping
D: Sexual dysfunction

A: Altered parenting

The mother who abuses cocaine puts her newborn and any other children at risk for neglect and abuse. The continued use of drugs has the potential to impact parenting behaviors. Social service referrals are indicated for evaluation and follow-up.

12

A nurse is caring for a client with end-stage heart failure. The family members are distressed about the client's impending death. Which intervention should the nurse take first?

A: Recommend an easy-to-read book on grief
B: Explain the stages of death and dying to the family
C: Ask about their present religious affiliations
D: Assess the family's patterns for dealing with death

D: Assess the family's patterns for dealing with death

When a new problem is identified, it is important for the nurse to first collect accurate information. This is crucial to ensure that the client and the family's needs are adequately identified in order to plan and implement nursing care. Once the situation has been assessed and a plan has been established, the nurse can focus on teaching or referral to other resources.

13

A nurse consistently ignores the call lights of clients who practice alternative lifestyles. The nurse's behavior is an example of what approach?

Prejudice

Discrimination

Stereotyping

Cultural insensitivity

Discrimination

Discrimination is the differential treatment of individuals because they belong to a minority group. This generally refers to the limiting of opportunities, choices, or life experiences because of prejudices against individuals, cultures or social groups.