question

confidentiality

answer

tell client's partner that his wife's lab results cannot be disclosed w/o her permission

question

advance directives

answer

will take effect when pt is unable to make health care decisions; client can make changes to it any time, signature with witness for the changes to take effect are necessary; can specify both desired and undesired care and medical treatment; upon admission, advance directive form is offered, but it is not a legal requirement to have one

question

before administering insulin

answer

obtain a capillary blood glucose reading

question

this client is a priority

answer

peripheral vascular disease pt that has absent pulse in the R foot

question

ok to delegate to AP

answer

measuring output of a mother's first voiding

question

AP upset that she has to care for all the incontinent patients, what to tell her:

answer

"I delegate tasks to the personnel based on their job descriptions" (RN will say this)

question

pt before tubal ligation that is unsure if thats the right thing for her to do, what to do about it..

answer

discuss with her about feelings about the procedure

question

stages of conflict

answer

stage 1-latent conflict (awareness of potential situations that can create conflict) stage 2-perceived conflict (those affected are discussing the situation but at an impersonal matter) stage 3-felt conflict (those affected become personally involved) stage 4-manifest conflict (those involved begin to take action) stage 5-conflict aftermath (those involved recognize the positive and negative outcomes in how the situation was managed)

question

orientation class for new clients/patients and their families; client rights:

answer

the right to be treated with respect and dignity; client does not have access to full facility but only to common areas of the facility; right to refuse their medications/treatment; right to leave regardless of provider recommendations (against medical advice); right to be fully informed (nurse has the responsibility to inform clients of their health conditions)

question

nurse is signing consent with client before a procedure; client has questions about alternative treatments:

answer

call the surgeon to discuss alternative treatments with client

question

RA client that has problems with buttoning her clothing; or needs help with ADL

answer

refer to occupational therapy

question

A client who had a R knee amputation 24 hrs ago

answer

can be given to a nurse with no experience (from different floor); the residual limb does not require special care now, initial dressing stays on for 48-72 hrs

question

Quality, cost effective care for a pt asking for supplies for his wound dressing, aat discharge time

answer

provide supplies for 1-2 days

question

case manager role for a pt discharged at home that needs daily IV antibiotics through PICC line

answer

ensure home infusion therapy has been arranged; make sure necessary referrals have been made so transition to home care is easy for client

question

home health nurse role

answer

assess client's home environment for possible reservoir of infection

question

environmental hazard at home-discuss it with parents

answer

the toilet seat lid is in the raised position

question

collaboration, mediation, negotiation

answer

conflict resolution strategies

question

Nurse performs the leadership task of Advocacy when:

answer

presenting an in service about preventing readmission of clients due to complications after joint replacement surgery

question

Safe use of wheel chair

answer

raise the footplates before transferring the pt-will prevent injury; lock brakes on both wheels when transferring pt; back the wheelchair into the elevator with the rear wheels first; stand between the wheelchair and the bottom of the incline when moving down the ramp;

question

staff members verbalize displeasure with changes on a unit-charge nurse action:

answer

role model a positive approach to the changes; encourage staff members to support the changes to discuss the issue with the resistant staff

question

Task ok to assign to LPN

answer

enteral feeding for a client with Crohn's disease; Reinforce teaching

question

Task ok to assign to RN

answer

blood transfusions initial teaching about insulin administration; PE client receiving IV Heparin

question

Client with diverticulitis si scheduled for surgery in 2 hrs, wants to leave hospital, nurse action

answer

notify the surgeon first; inform client about risks she may encounter-peritonitis

question

Sterile dressing change

answer

correct action: pick up the sterile glove by grasping the folded cuff edge First; use sterile gloves to apply the transparent dressing; open the top flap of the sterile package away from the body; maintain a 2.5 cm/1 in border around the edges of the sterile field

question

client in ER with weakness, vomiting, diarrhea for last three days

answer

priority assessment: serum K level

question

client that refuses blood transfusions due to religious beliefs

answer

RN should support client's decision to forego transfusions

question

charge nurse response to a nurse who thinks her client is in the ER just to seek drugs and not actually experiencing pain

answer

Clients are the experts on their own pain

question

INTRApersonal conflict example

answer

"I'm not sure whether I want to apply for the unit manager's position or start a family this year"

question

client in ER arriving with stage IV pressure ulcers, maggots presence (brought by family member), nurse's responsability

answer

notify Adult Protective Services, provider and social worker; no need to call police or confront family member

question

Chlamydia trachomatis

answer

nationally notifiable infectious disease (notify state health dept) (RSV, MRSA or Cdif are not)

question

advance directives

answer

a family member of a client can have the living will overturned in some cases (family members can question the mental capacity of the client at the time a living will was completed-this might get the will revoked); no prescription necessary;

question

Dementia client best spot

answer

private room near nurse's station

question

ok to delegate to AP

answer

ambulating a client who uses a walker; adding thickener to thin liquids on a client's food tray; ambulate a client who is 12 hrs postop eye surgery

question

RN will

answer

complete an admission assessment for a client who has just transferred from the emergency department

question

LPN

answer

inserts an indwelling catheter for a client who has not voided for 6 hrs; obtain sterile specimen from a client's infected surgical wound

question

nurse suspects that her coworker is impaired-responsibility

answer

notify charge nurse

question

Priority client

answer

abdominal surgery 6 hrs ago with HR of 120/min for the last 2 hrs

question

pump that infused too much solution

answer

after notifying provider, tag the pump for maintenance and acquire a new pump for the client; don't use again

question

critical pathway

answer

include treatment milestones (time bound activities, interventions, outcomes)

question

priority client

answer

fractured hip with recently developed slurred speach

question

UTI increased # of cases on a floor; manager first action

answer

perform a chart review to gather data about clients who develop the infections

question

this is wrong-requires intervention

answer

photocopying clients dignostic test results

question

report to charge nurse

answer

client 2 days post of with urine 20 ml/hr-risk for acute kidney injury

question

priority client

answer

arm contusions with asymmetrical thoracic movement=tension pneumothorax

question

quality improvement process first step (reducing UTI on a unit)

answer

establish best practices guidelines for reducing the incidence of UTI's-this will create a standard in order to measure performance

question

LPN

answer

can irrigate wounds

question

Effective time management skills shown by new RN when:

answer

she makes a list of non-essential tasks to perform later

question

In case of a major accident, when a disaster plan has been activated, what a charge nurse can do in PACU

answer

identify stable clients to transfer to a surgical unit

question

Report for transferring client thats 3 days postop; this should include

answer

objective data: eg. level of consciousness, vitals for current shift, essential background info that pertains to client status, dont include routine care procedures like dressing change schedule

question

client on warfarin most important to include in plan of care

answer

scheduling follow up test for prothrombin time and INR

question

Authoritarian manager that needs to address increased meds errors

answer

will inform the staff of the penalties that can result from meds errors (penalties for behaviour change)

question

this requires completion of an incidence report

answer

a client's IV solution infused over 6 hrs instead of 8 hrs

question

in a disaster

answer

LPN can provide care to class III (green tag) clients

question

LPN report very high BP to RN on a client; RN initial action

answer

recheck BP

question

Meningococcal pneumonia

answer

droplet precautions

question

shigella

answer

contact precautions

question

MRSA

answer

contact

question

respiratory syncytial virus

answer

contact

question

when applying restraints

answer

place restraint ties on a movable part of the bed frame; on the wrist; quick release knot, not square; over client's clothing

question

critical pathways

answer

prevent unnecessary expense, Evidence based strategies for common dx

question

to promote employee hand hygiene

answer

first thing: set a goal for improvement in adherence

question

class about strategies to promote client rights

answer

verify that a provider prescription is in the medical record for clients who have restraints

question

Fire in a unit: priority

answer

instruct ambulatory clients to go to a safe area (RACE)

question

informed consent for a child

answer

must be given by a legal guardian and not by a friend's parent

question

active herpes simplex lesions

answer

contact precautions: gown and gloves

question

client with cancer decides not to continue treatment

answer

"tell me what this is like for you?"

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