Chapter 1: Professional Nursing Practice

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Questions and Answers

What is the primary nursing diagnosis related to the presence of a pressure ulcer?

Impaired skin integrity (correct)
Deficient fluid volume
Risk for infection
Ineffective tissue perfusion

Which strategy is most effective in treating altered circulation and pressure for a patient with impaired skin integrity?

Administering pain relief medication
Frequently repositioning the patient (correct)
Increasing the patient's mobility
Providing nutritional supplements

What is the most appropriate outcome for a patient diagnosed with deficient fluid volume due to excessive diaphoresis?

Patient's hydration status is monitored
Patient has balanced intake and output (correct)
Patient's bedding is changed every hour
Patient expresses understanding of fluid needs

What is the primary purpose of the evaluation phase in the nursing process?

To assess effectiveness of interventions (A) Signup and view all the answers

What is the goal of the assessment phase in the nursing process?

To collect data for diagnosing patient issues (D) Signup and view all the answers

Which nursing action is least effective for a patient with impaired skin integrity?

Administering medications for weakness (D) Signup and view all the answers

In the context of nursing, what does 'ineffective tissue perfusion' indicate?

Insufficient blood flow to the tissues (A) Signup and view all the answers

If a nurse assesses a patient with a bacterial infection and notes they are excessively sweating, what should be of primary concern?

Fluid balance and volume (A) Signup and view all the answers

What is the primary purpose of the assessment phase in nursing?

To identify realistic outcomes for health problems (B) Signup and view all the answers

Which nursing diagnosis statement is properly structured?

Ineffective coping related to response to biopsy test results (C) Signup and view all the answers

Which component is essential to include in a nursing diagnosis statement?

The problem with an etiology and the signs and symptoms (B) Signup and view all the answers

Which task is appropriate to delegate to an experienced UAP for a patient with heart failure?

Obtain the patient’s blood pressure and pulse rate after ambulation (C) Signup and view all the answers

What type of facility should the nurse arrange for the patient's transfer?

Transitional care facility (A) Signup and view all the answers

Why is the use of medical diagnoses considered inappropriate in nursing diagnosis statements?

They do not indicate the patient's response to a health problem (C) Signup and view all the answers

Which task is appropriate to delegate to the home health aide for a patient diagnosed with type 2 diabetes?

Help the patient with a daily bath and oral care (B) Signup and view all the answers

What is a defining characteristic in writing a nursing diagnosis?

Observable signs and symptoms present in the patient (A) Signup and view all the answers

How are hospitals primarily reimbursed for patient care?

Primarily on clinical outcomes and patient satisfaction (A) Signup and view all the answers

Which option correctly describes a component of nursing diagnosis writing?

Stating the problem, its cause, and supporting data (A) Signup and view all the answers

In the context of nursing diagnosis, what does NANDA stand for?

Nursing Diagnosis Association of North America (B) Signup and view all the answers

Which statement accurately reflects the responsibilities of nurses regarding care delivered by others?

Nurses must coordinate all aspects of patient care including care provided by others. (B) Signup and view all the answers

Which condition suggests that a patient is not yet ready for a residential care facility?

The patient requires ongoing medical assessments. (C) Signup and view all the answers

What type of infections would negatively impact hospital reimbursement?

Catheter-related infections (B) Signup and view all the answers

Which of the following tasks should NOT be delegated to the home health aide?

Teaching self-management skills for diabetes (D) Signup and view all the answers

What is a characteristic of a transitional care facility?

It serves patients needing rehabilitation before discharge. (D) Signup and view all the answers

Which task is inappropriate to delegate to an unlicensed assistive personnel (UAP)?

Check for the presence of bowel sounds and flatulence (B) Signup and view all the answers

What task can a nurse delegate to a licensed practical nurse (LPN/LVN)?

Obtain bedside blood glucose before insulin administration (D) Signup and view all the answers

What is the primary role of a case manager in a healthcare setting?

Coordinate the services that the patient receives (D) Signup and view all the answers

Which statement accurately reflects the responsibilities of a registered nurse (RN) in a team?

Responsible for supervision and team coordination (C) Signup and view all the answers

What type of task would an unlicensed assistive personnel (UAP) be unable to perform?

Assess a patient's neurological status (B) Signup and view all the answers

Which task could a registered nurse (RN) properly assign to a float RN in the unit?

Performing an initial assessment for a newly admitted patient (C) Signup and view all the answers

What is an example of a task requiring a registered nurse's expertise that should not be delegated?

Providing patient education on medication (B) Signup and view all the answers

In a situation involving a patient with complex needs, which action should a case manager prioritize?

Coordinating care between various healthcare providers (A) Signup and view all the answers

Which statement demonstrates a correct understanding of the nursing process?

The nursing process is a problem-solving tool used to identify and treat patients’ health care needs. (D) Signup and view all the answers

What is the first action a nurse should take when a patient expresses discomfort about child care arrangements?

Gather more data about the patient’s feelings about the child-care arrangements. (A) Signup and view all the answers

What nursing diagnosis is most appropriate for a patient who is paralyzed on the left side following a stroke and has developed a pressure ulcer?

Impaired skin integrity related to altered circulation and pressure. (B) Signup and view all the answers

In the nursing process, which phase follows the assessment of a patient's needs?

Diagnosis of the patient's health issues. (A) Signup and view all the answers

Which is NOT a primary use of the nursing process?

To explain interventions to healthcare teams. (A) Signup and view all the answers

What is an essential component of the nursing process during the assessment phase?

Gathering comprehensive patient information. (A) Signup and view all the answers

Which of the following describes a characteristic of the nursing diagnosis?

It identifies patient problems that require nursing intervention. (C) Signup and view all the answers

When planning care for a patient with a pressure ulcer, which aspect should the nurse prioritize?

Regularly assessing the skin condition. (B) Signup and view all the answers

Which action is considered the highest priority when a nurse is working to promote patient safety?

Ensuring client safety (A) Signup and view all the answers

What should a nurse include when preparing a patient for discharge to enhance safety?

Providing a list of current medications to the patient and caregiver (A) Signup and view all the answers

In which order should the nurse communicate patient status using the SBAR format?

D, B, C, A (B) Signup and view all the answers

Which of the following actions does NOT directly contribute to improving patient safety?

Prioritizing the nurse’s own comfort in the workplace (A) Signup and view all the answers

What practice helps clients promote their own safety while hospitalized?

Encouraging the client and family to be active partners in care (A) Signup and view all the answers

What is a key component of the nurse's assessment in promoting patient safety during medication administration?

Identifying potential side effects and interactions (A) Signup and view all the answers

Which scenario represents a failure in ensuring patient safety?

The caregiver does not monitor hand hygiene (B) Signup and view all the answers

Which of the following is an inappropriate response to a patient showing signs of distress?

Ignoring the symptoms until the scheduled assessment (C) Signup and view all the answers

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Flashcards

Assessment Phase

The initial step in the nursing process where the nurse gathers information about the patient's health status, including their physical, psychological, social, and spiritual needs.

Nursing Diagnosis

A statement that describes a patient's actual or potential health problem. It includes the problem itself, the cause, and the signs and symptoms.

Actual Nursing Diagnosis

A nursing diagnosis statement that describes a patient's actual health problem, including the problem, its cause, and the signs and symptoms.

Risk Nursing Diagnosis

A nursing diagnosis statement that describes a potential health problem that the patient is at risk for developing. It includes the problem and the risk factors that may contribute to the problem.