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Questions and Answers
What type of report is given at the end of a shift so that the next nurse can follow the appropriate treatment plan and care for the patient?
What type of report is given at the end of a shift so that the next nurse can follow the appropriate treatment plan and care for the patient?
Which section of the health record includes information needed to contact the guardian of a patient?
Which section of the health record includes information needed to contact the guardian of a patient?
Which response by the nurse is accurate for a patient requesting a copy of the patient's medical record?
Which response by the nurse is accurate for a patient requesting a copy of the patient's medical record?
Which method would the nurse use to dispose of printed patient information?
Which method would the nurse use to dispose of printed patient information?
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Which system in the electronic health record (EHR) provides warnings to alert a health care provider of patient allergies when prescribing medications?
Which system in the electronic health record (EHR) provides warnings to alert a health care provider of patient allergies when prescribing medications?
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Which organization addresses the quality of health care documentation? SATA
Which organization addresses the quality of health care documentation? SATA
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In which section of the patient health record would the nurse enter subjective and objective data?
In which section of the patient health record would the nurse enter subjective and objective data?
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Which characteristic is an advantage of effective documentation? SATA
Which characteristic is an advantage of effective documentation? SATA
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Which system enables the ability to review patient education information provided to the patient during previous appointments?
Which system enables the ability to review patient education information provided to the patient during previous appointments?
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Which action reflects how medical insurance companies use documentation of a patients health information?
Which action reflects how medical insurance companies use documentation of a patients health information?
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Which location in the patient's health record is used to document urine output?
Which location in the patient's health record is used to document urine output?
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Which section of health record maintains demographic information?
Which section of health record maintains demographic information?
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Which section of health record maintains demographic information?
Which section of health record maintains demographic information?
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Which step of the SOAP format documentation reflects the nurse's interpretation of patient date?
Which step of the SOAP format documentation reflects the nurse's interpretation of patient date?
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Which statement made by the nursing student indicates a need for further teaching regarding electronic and written documentation?
Which statement made by the nursing student indicates a need for further teaching regarding electronic and written documentation?
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Which element would the nurse document after administering a medication to a patient? SATA
Which element would the nurse document after administering a medication to a patient? SATA
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Which system helps health care organizations comply with the requirements of accrediting agencies?
Which system helps health care organizations comply with the requirements of accrediting agencies?
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Which system is involved in providing built-in reminders and alerts for prescribing medications and diagnostic tests?
Which system is involved in providing built-in reminders and alerts for prescribing medications and diagnostic tests?
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Which correction is accurate after documentation of a wrong medication?
Which correction is accurate after documentation of a wrong medication?
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Which factor would the nurse consider when designing a teaching form for patients being discharged?
Which factor would the nurse consider when designing a teaching form for patients being discharged?
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Which statement requires correction regarding legal guidelines of handwritten documentation?
Which statement requires correction regarding legal guidelines of handwritten documentation?
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Which law is the nurse violating when faxing a patient's medical record to an unknown number?
Which law is the nurse violating when faxing a patient's medical record to an unknown number?
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A new grad nurse is providing a telephone report to a patient's health care provider and accepting telephone prescriptions from the provider. Which action requires the new nurse's preceptor to intervene?
A new grad nurse is providing a telephone report to a patient's health care provider and accepting telephone prescriptions from the provider. Which action requires the new nurse's preceptor to intervene?
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Which statement made by the nurse is true regarding clinical information system?
Which statement made by the nurse is true regarding clinical information system?
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How would the nurse respond to a patient who asked the nurse to explain HIPAA?
How would the nurse respond to a patient who asked the nurse to explain HIPAA?
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Which action would the nurse perform after receiving new patient prescriptions from a health care provider by telephone? SATA
Which action would the nurse perform after receiving new patient prescriptions from a health care provider by telephone? SATA
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Which actions meet legal guidelines for nursing documentation? SATA
Which actions meet legal guidelines for nursing documentation? SATA
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Which item is a feature of charting by exception? SATA
Which item is a feature of charting by exception? SATA
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Which outcome is expected from effective documentation? SATA
Which outcome is expected from effective documentation? SATA
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Which statement describes the purpose of the incident report?
Which statement describes the purpose of the incident report?
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Which charting error can lead to malpractice lawsuits? (SATA)
Which charting error can lead to malpractice lawsuits? (SATA)
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Which patient information would the nurse exclude from mentioning during an educational conference (SATA)
Which patient information would the nurse exclude from mentioning during an educational conference (SATA)
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Which action would the nurse take in documenting patient care ?
Which action would the nurse take in documenting patient care ?
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Which is the mode for exchanging information among members of the health care team?SATA
Which is the mode for exchanging information among members of the health care team?SATA
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Which patient information is objective data?
Which patient information is objective data?
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A patient has a temperature of 100.2, RR of 28bpm, and HR of 98 bpm, reports discomfort in the abdomen, and fatigue. Which item represents objective data? SATA
A patient has a temperature of 100.2, RR of 28bpm, and HR of 98 bpm, reports discomfort in the abdomen, and fatigue. Which item represents objective data? SATA
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Which information describes a characteristic of the electronic health record as compared with paper-based documentation systems? SATA
Which information describes a characteristic of the electronic health record as compared with paper-based documentation systems? SATA
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Provider prescribes a clear liquid diet for a patients. How would the nurse document the outcome of this prescription?
Provider prescribes a clear liquid diet for a patients. How would the nurse document the outcome of this prescription?
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As you enter the patient's room, you notice that he is anxious to say something. He quickly states, "I don't know what's going on; I can't get an explanation from my doctor about my test results. I want something done about this." Which option is the most appropriate documentation of the patient's emotional status?
As you enter the patient's room, you notice that he is anxious to say something. He quickly states, "I don't know what's going on; I can't get an explanation from my doctor about my test results. I want something done about this." Which option is the most appropriate documentation of the patient's emotional status?
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Which guidelines would the nurse follow regarding the patient's EHR? SATA
Which guidelines would the nurse follow regarding the patient's EHR? SATA
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using SOAP format, which represents the appropriate P statement?
using SOAP format, which represents the appropriate P statement?
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Which documentation would the nurse include after administration of an enema to the patient? SATA
Which documentation would the nurse include after administration of an enema to the patient? SATA
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Which statement is a complete and accurate example of charting a patient's activity?
Which statement is a complete and accurate example of charting a patient's activity?
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Which information would be included in the objective section of a progress note in SOAP?
Which information would be included in the objective section of a progress note in SOAP?
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In which way does SOAP differ from PIE charting?
In which way does SOAP differ from PIE charting?
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Study Notes
Blood Glucose Monitoring
- Peripheral Vascular Disease (PVD): When selecting a finger puncture site for a patient with PVD, choose a site away from the affected extremity.
- Delegation of Blood Glucose Monitoring: Nursing assistive personnel (NAP) can perform routine blood glucose monitoring for patients with stable diabetes. Do not delegate this task for patients with unstable diabetes or if there are changes in the patient's condition.
- Interruption of Blood Glucose Testing: Cloudy blood glucose test results should not be used.
- Self-Monitoring Blood Glucose: If a patient with type 2 diabetes is self-monitoring six times a day, ensure they understand the frequency and timing of their testing and discuss any changes in their regimen.
Nasogastric Tube Insertion and Management
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Alternative to Nasogastric Tube Placement: If unable to insert a nasogastric tube in either nare, explore alternative feeding options:
- Orogastric tube: A tube inserted through the mouth into the stomach.
- Gastrostomy or jejunostomy: Surgical placement of a feeding tube directly into the stomach or small intestine.
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Resistance During Insertion: If you encounter resistance during nasogastric tube insertion, stop and assess the situation. Possible causes:
- The tube is lodged at the back of the throat
- The tube is hitting the back of the throat.
- The tube is inserted into the wrong nostril.
- The tube is meeting resistance due to a blockage.
- Nasogastric Tube Contraindications: There are no medical conditions that specifically contraindicate nasogastric tube placement.
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Nasogastric Tube Discomfort: To reduce patient discomfort before inserting a nasogastric tube:
- Explain the procedure to the patient.
- Lubricate the tube and ensure adequate insertion technique.
- Administer pain medication if needed.
- Delegation of Nasogastric Tube Insertion: Nursing assistive personnel (NAP) can assist with the insertion procedure, such as holding the patient's head in a neutral position.
- Nasogastric Tube Feeding and Aspiration: When feeding a patient with a nasogastric tube, it's important to ensure the tube remains in place by using a safety strap. Monitor for signs of aspiration throughout the feeding.
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Patient Safety During Feeding: While feeding a dependent patient, nursing assistive personnel should:
- Watch the patient during each bite to make sure the patient safely swallows the food.
- Stop feeding if the patient shows signs of choking or aspiration.
- Encouraging Self-Feeding: When assisting a patient who has difficulty self-feeding, encourage self-feeding to promote independence and maintain their skills whenever possible.
- Post-Swallow Assessment: Nursing assistive personnel should ensure the patient safely swallowed their food by looking for ** signs of aspiration** like coughing, choking, or difficulty breathing.
- Flatus Before Feeding: Determining if the patient is passing flatus indicates gastric motility, which helps determine if a patient is ready for a meal.
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Nasogastric Tube Removal: Minimizing patient anxiety during nasogastric tube removal:
- Explain the procedure to the patient.
- Administer pain medication if needed.
- Use a slow and steady withdrawal of the tube.
- Nasogastric Tube Removal Contamination: To minimize risk of contamination during removal, wear gloves, clamp the tube before removing it, and dispose of the tube appropriately.
- Equipment for Nasogastric Tube Removal: You will need a clamp and a container for disposal.
- Nasogastric Tube Removal Delegation: Nursing assistive personnel (NAP) can **monitor the patient **for signs of distress or discomfort following the removal of the tube.
- Clamping the Nasogastric Tube: Before removing the tube, clamp it off to prevent aspiration and ensure no gastric contents leak out.
Subcutaneous Insulin Injection
- Minimizing Tissue Irritation: To diminish tissue irritation during subcutaneous injection, pinch the skin at the injection site to create a "tent" and inject the medication into the tent.
- Appropriate Needle for Injection: For a subcutaneous injection on an average-sized adult, a 25-gauge, 5/8-inch needle is appropriate.
- Subcutaneous Injection Discomfort: To minimize discomfort, use a syringe that is appropriate for the volume of the injection, rotate injection sites, and warm the insulin to room temperature before administration.
- Preferred Site: The abdomen is the preferred injection site for subcutaneous heparin or insulin.
- Site Selection for Insulin: To ensure proper site selection for subcutaneous insulin injection, rotate among different sites within the preferred area to minimize tissue damage and improve absorption.
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Insulin Safety: To ensure the patient's safety when preparing insulin:
- Verify the insulin type and dose.
- Inspect for clarity and color (cloudiness indicates damage).
- Use proper aseptic technique when mixing insulin.
- Insulin Efficacy: To ensure insulin is effective, rotate injection sites regularly. Also, store insulin properly, as exposure to heat can damage the medication.
- Blood Glucose Levels and Insulin: A short-acting insulin injection, such as Humulin-R, will have the most significant impact on blood glucose levels immediately before and after the injection.
- Insulin Administration Accuracy: When administering insulin, never mix types without consulting a physician or pharmacist.
- Insulin Timing: Rapid-acting insulin should be administered 15 minutes before meals to coincide with the peak onset of action.
Enteral Feeding
- Head of Bed Elevation: Elevating the head of the bed to 30 degrees for a patient receiving an intermittent tube feeding helps prevent aspiration by promoting gastric emptying.
- Closed-System Enteral Feeding Management: If a closed-system enteral feeding has 150 mL of formula remaining and the infusion rate is 50 mL/hr, observe the patient for signs of hunger and consider adjusting the feeding schedule or notify the physician.
- Flushing a Nasogastric Tube: If unable to flush a nasogastric tube with water, attempt flushing with saline solution (check for any contraindications with the patient) or notify the physician.
- Nasogastric Tube Patency: To assess nasogastric tube patency, check for any signs of blockage, aspirate gastric contents, or flush the tube with a small amount of fluid.
- Gastric Residual: If the gastric residual is 50mL, hold the feeding, assess the patient for signs of distress, and contact the physician.
- Risk for Dysphagia: Patients with neuromuscular disorders are most at risk for dysphagia.
- Nursing Assistive Personnel (NAP) Reporting: When feeding any patient on aspiration precautions, the NAP should immediately report any signs of aspiration such as coughing, choking, or difficulty breathing.
- Preventing Aspiration: The most effective way to prevent aspiration is to ensure the patient is sitting upright during feeding and to clear the mouth before each bite.
- Dysphagia Diet: Thick liquids and pureed foods would not be given to a patient on a dysphagia diet.
- Patient with Dysphagia: Before feeding a patient with dysphagia, the nurse should provide nursing assistive personnel (NAP) with special instructions about the patient's feeding routine.
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Description
This quiz focuses on the best practices for measuring blood glucose levels in patients with type 2 diabetes mellitus, especially considering the complications such as peripheral vascular disease (PVD). Understand the critical importance of puncture site selection and its benefits for such patients.
