question

RN Duty: Informed Consent

answer

Review Previously provided info about the procedure

question

Sealed Radiation Therapy Implant

answer

Visitors- max of 30min per day and stay 6ft away from client Keep Pt in a Private Room RN to avoid turning back to pt when wearing a lead apron

question

HC associated Infections on unit; Auditing Quality Control Process RN's First Action to Take:

answer

Use Benchmarks to establish standards

question

E.D. admitting pt's after an earthquake. Emerg Disaster Plan is implemented; large number of casualties. Which Pt needs immediate evaluation by a provider?

answer

Crushing Chest Wound (Red Tag) Massive Head Injury (Blk- little to no chance of survival) Open compound fractures in both legs (Yellow-can wait a short time) 6inch scalp laceration (Green- non-emergent)

question

New RN & AP arguing over AP not restocking unit supplies. AP leaves, Nurse Mgr tells RN:

answer

"I would like you to approach the AP to resolve the problem" Encourage Face-to-face communication to resolve the conflict

question

An occupational health nurse is triaging pts at the site of an industrial explosion. Example of a Green Tag (Class III) Pt:

answer

Facial Contusion- Green Open Femur Fracture- Yellow Hypovolemic Shock- Red Penetrating spinal Injury- Red

question

Med-Surg Acute care facility. Which event requires an incident report?

answer

Med administered 45 min late because it was unavailable. Acceptable practice is 30 min before or after ordered time.

question

Presentation of "Role of the Nurse as a Client Advocate;" What should nurse mgr include in presentation?

answer

nfo about confidentiality disclosure is an example of an RN being a pt advocate

question

Shift assignments: RN, LPN & AP; Which task can be delegated to an LPN?

answer

Reinforcing Teaching to a client- LPN Vitals- AP Post-mortem care- AP Simple Dressing Change- AP

question

Annual performance review for a staff nurse; Strategies to be used in the review process:

answer

Include Peer Reviews by AP, Have Nurse complete a self-appraisal prior to the review, conduct a performance checklist

question

Indicator of neglect: Older pt w/ dementia

answer

Meds brought to hospital are expired

question

Home Health RN teaching about online resources regarding validity of information; Most credible source source of information:

answer

Website affiliated with a government agency

question

Alzheimer's Pt's Daughter, "I don't know how much longer I can keep this up"

answer

RN Response, "Let's discuss options for respite care"

question

LPN's & AP's; Charge nurse should intervene in what situation:

answer

LPN develops POC for a pt with pneumonia; This is not within the scope of practice for an LPN

question

Immediate Intervention:

answer

Pt with Hx of esophageal varices who has diaphoresis and pallor. Diaphoresis and pallor indicate pt may be hemorrhaging from ruptures esophageal varices.

question

Which situation indicates a legal issue:

answer

phlebitis at IV site that was placed 4 days ago. IV has been in place too long. Failure to meet the standard of care and a possible long-lasting injury to the client.

question

Advanced Directives:

answer

Must be documentation in the MR about whether a client has AD's or not

question

Effective Communication regarding delegation to AP

answer

"Check urinary output at 11am for John Doe and report to me immediately"

question

Massive Community Disaster; DC Stable pt's, Who is safe to DC?

answer

Pt with MS that reports ataxia (Ataxia an expected finding with MS)

question

Terminally Ill pt; RN is participating in an ethical manner:

answer

Collaborate with client to establish realistic goals for her end-of-life care

question

Immediate Intervention:

answer

Substernal chest discomfort (4/10)

question

RN reprimanded by provider in front of client:

answer

Discuss situation with provider in private

question

Pt recovering from a MVA & needs ADL's assistance; RN to request a referral for:

answer

OT

question

Home Health RN gets labs for 4 pt's. Who should she see first?

answer

Platelets of 100,000/mm3. Decreased platelet count labels pt as unstable and is the highest priority.

question

Demonstrates the AP is using effective time-management skills

answer

grouping activities for several clients in the same location

question

older client with expressive aphasia. RN did not get informed consent prior to:

answer

This procedure does not require an informed consent

question

Postop pt with PCA; Restless, elevated pulse, decreased BP; RN's action:

answer

Place pt in modified trandelenburg

question

Smoke in Wastebasket

answer

R- Rescue Pt A- Activate Alarm C- Contain the Fire/Smoke E- Extinguish

question

Spanish Speaking Pt

answer

Use Spanish/English medical dictionary to assist, ask Spanish speaking AP that is assigned to client to assist, Request hospitals interpreter to provide education

question

Newborn is being DC'd; RN's best action to ensure newborn safety:

answer

Observe parents securing newborn into infant care seat in parents car

question

Terminally ill w/ nutritional support. Children disagree with continuation of support, referred to ethics committee. What should RN do?

answer

Assist with weighing options involved in the decision

question

3 days post op: open reduction with internal fixation of the right hip. Discussion priority:

answer

Refusing PT

question

Policies regarding electronic medical records

answer

Will shred printouts when finished with assignements

question

Local chemical plant explosion; RN's priority intervention when pt's arrive:

answer

Isolate clients and irrigate with water

question

Pt with dementia

answer

place client in a room near the nurses station

question

Abdominal Pain Pt admitted, what MUST be performed by the RN:

answer

Admission Assessment

question

Newborn & Mother who requires apnea monitoring at home. Who should the client be referred to?

answer

Home Health

question

Renal Failure Client stops dialysis. RN's action shows patient advocacy:

answer

Supports the clients decisions to DC treatment

question

Health Care Law info:

answer

Patient Self-Determination Act requires an RN to give clients info about end-of-life options

question

At what time during a hospital stay should the nurse assess the clients DC planning?

answer

At the time of the admission interview

question

Suspected TB:

answer

wear a particulate respirator mask

question

Adherence to HIPAA guidelines

answer

shares test results with an AP on the same nursing team

question

Pt complains of call light not being answered timely

answer

ask pt to verbalize his expectations

question

Pain assessments not being performed as required by policy

answer

Report to Nurse Mananger

question

conflict management with staff who does not agree with assignment. Example of "smoothing strategy"

answer

"You always do a great job and I think you can handle this.

question

Progressive Discipline Steps:

answer

Informal Reprimand, Formal written reprimand, suspend without pay, terminate employee

question

18 yr old: does not want chemo again. Which is consistent with the clients rights?

answer

"I can gather info on palliative care for you."

question

which patient may give an informed consent?

answer

Blood alcohol level of 0.05

question

Charge nurse notices an RN has made 2 med errors in 1 shift and suspects RN is chemically impaired. First action:

answer

remove the staff member from the work environment

question

Poor attendance at staff meetings. Which should charge nurse do first?

answer

explore the reasons staff are not attending meetings

question

Highest Priority

answer

Adult client with a femur fracture reporting SOB

question

How to use Evidenced Based Practice to improve client outcomes. Recommend as a qualitative research method:

answer

Phenomenology; used for studying participants' experiences.

question

Home oxygen therapy needs further teaching

answer

oxygen concentration is plugged into an extension cord.

question

Cancer pt vomits blood on linens and floor.

answer

mop floor with a bleach solution. Clean PATIENT with chlorhexidine gluconate solution; not floor

question

validate that client understands the procedure (after pt has signed informed consent):

answer

Ask the client to verbalize the purpose, risks and benefits of the procedure.

question

2 nurses say the other is not "doing their fair share." What is an appropriate approach to this conflict?

answer

Explore alternative solutions to address unit workflow with the nurses.

question

Which of the following actions should the nurse take to ensure the AP is qualified to perform a particular task?

answer

Review the AP's skill competency checklist

question

Pt with AMS and R lower leg deep vein thrombosis has a prescription for application of aquathermia pad to the lower right leg. Nursing priority actions:

answer

check pt's leg 10 min after applying the aquathermia pad

question

Nurse Managers Highest Priority:

answer

assigning client care to staff

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