Chapters: 15, 21, 24, 22, 25, 26

Questions and Answers

(Ch.15) A nurse enters a patient’s room at the beginning of a shift to assess his condition following a blood transfusion. The nurse cared for the patient on the previous day as well. The patient has several issues he wishes to share with the nurse, who takes time to explore each issue. The nurse also assesses the patient and finds no signs or symptoms of a reaction to the blood product. The nurse observed the patient the prior day and sees a change in his behavior—a reluctance to get out of bed and ambulate. Which of the following actions improve the nurse’s ability to make clinical decisions about this patient? (Select all that apply.)

Knowing the early mobility protocol guidelines

Spending time during the patient assessment (correct)

Knowing the pattern of patient behavior about ambulation (correct)

Caring for the patient on consecutive days (correct)

(Ch.15) A nurse has seen many cancer patients struggle with pain management because they are afraid of becoming addicted to the medicine. Pain control is a priority for cancer care. By helping patients focus on their values and beliefs about pain control, a nurse can best make clinical decisions. This is an example of:

Creativity

Fairness

Clinical reasoning

Applying ethical criteria (correct)

(Ch.15) The REFLECT model can improve learning after providing patient care. Place the steps of this model in the correct order:

Think about your thoughts and actions at the time of a situation.

Review the knowledge you gained from the experience.

Review the facts of the situation.

Set a schedule for completing your plan of action.

Consider options for handling a similar situation in the future.

Recall any feelings you had at the time of the situation.

Create a plan for future situations.

3, 1, 6, 2, 5, 7, 4 (correct)

6, 1, 3, 5, 2, 7, 4

1, 2, 5, 4, 6, 7, 3

4, 7, 2, 5, 3, 1, 6

(Ch.15) One element of clinical decision making is knowing the patient. Which of the following activities affect a nurse’s ability to know patients better? (Select all that apply.)

Caring for similar groups of patients over time Signup and view all the answers

(Ch.15) A nurse is preparing medications for a patient. The nurse checks the name of the medication on the label with the name of the medication on the health care provider’s order. At the bedside, the nurse checks the patient’s name against the medication order as well. The nurse is following which critical thinking attitude?

Responsibility Signup and view all the answers

(Ch.15) A nurse has been caring for a patient with a chronic wound that has not been healing. The nurse talks with a nurse specialist in wound care to find alternative approaches from what the health care provider ordered for dressing the wound. The two decide that because of the patient’s allergy to tape, a nonallergenic dressing will be used. The nurse obtains an order from the health care provider for the new dressing. After 2 days there is improvement in the wound. This is an example of which critical thinking standards? (Select all that apply.)

Relevance Signup and view all the answers

(Ch.15) A nurse is assigned to care for a woman who is expecting her first child. The nurse organizes herself and plans to gather data about the patient by applying Pender’s health promotion model, including the patient’s characteristics and experiences and situational influences. She plans to observe patient behavior and consider the patient’s psychosocial issues. Such data will offer a clear understanding to help the nurse identify the patient’s needs. This is an example of which of the following concepts? (Select all that apply.)

Deductive reasoning Signup and view all the answers

(Ch.15) A nurse is caring for a patient who has poor pain control. The patient has a history of opioid abuse. During the day, the patient made frequent requests for a pain medication. To make an effective clinical decision about this patient, the nurse needs to ask questions about the data available on the patient to make a thorough and thoughtful decision. The nurse asks herself, “How does my view about the patient’s pain tolerance compare with the patient’s, and does that pose a problem?” This is an example of:

A question about perspective Signup and view all the answers

(Ch.15) A nurse is giving a patient a medication and notices the dosage. From the nurse’s experience, the dosage is higher than what is normally given. Which of the following steps should the nurse take to ensure a safe outcome for the patient? (Select all that apply.)

Recognize how the nursing team communicates problems, and consult with charge nurse. Signup and view all the answers

(Ch.21) At 1300 the registered nurse (RN) says to the assistive personnel (AP), “You did a good job transferring Mr. Harvey into his chair this morning at 0830. I saw that you recorded how long he stayed in his chair. I saw that Mr. Harvey did not have any shoes or nonslip slippers on, though. For safety, the next time you transfer a patient into a chair, you need to make sure that the patient wears slippers or shoes. Please get Mr. Harvey up in his chair again by 1500.” Which characteristics of positive feedback did the RN use when talking to the AP? (Select all that apply.)

Feedback focuses on one issue. Signup and view all the answers

(Ch.21) A nurse received change-of-shift reports on these four patients and starts rounding. Which patient does the nurse need to focus on as a priority?

A patient admitted yesterday with atrial fibrillation who now has a decreased level of consciousness Signup and view all the answers

(Ch.21) A nurse asks an AP to help the patient in Room 418 walk to the bathroom right now. The nurse tells the AP that the patient needs the assistance of one person and the use of a walker. The nurse also tells the AP that the patient’s oxygen can be removed while he goes to the bathroom but to make sure that when it is put back on, the flowmeter is still at 2 L. The nurse also instructs the AP to make sure the side rails are up and the bed alarm is reset after the patient gets back in bed. Which of the following components of the “Five Rights of Delegation” were used by the nurse? (Select all that apply.)

Right task Signup and view all the answers

(Ch.21) While administering medications, a nurse realizes that a prescribed dose of a medication was not given. The nurse acts by completing an incident report and notifying the patient’s health care provider. Which of the following is the nurse exercising?

Accountability Signup and view all the answers

(Ch.21) Which task is appropriate for a registered nurse (RN) to delegate to an AP?

Helping the patient to the bathroom before leaving for the operating room Signup and view all the answers

(Ch.21) A nurse performs the following four steps in delegating a task to an AP. Place the steps in the correct order of appropriate delegation.

Do you have any questions about walking with Mr. Malone?

Before you take him for his walk to the end of the hallway and back, please take and record his pulse rate.

In the next 30 minutes please assist Mr. Malone in Room 418 with his afternoon walk.

I will make sure that I check with you in about 40 minutes to see how the patient did.

3, 2, 4, 1 Signup and view all the answers

(Ch.21) Which example demonstrates a nurse performing the skill of evaluation?

After completing a teaching session, the nurse observes a patient drawing up and administering an insulin injection. Signup and view all the answers

(Ch.21) The nurse manager from the surgical unit was awarded the nursing leadership award for practice of transformational leadership. Which of the following are characteristics or traits of transformational leadership displayed by the award winner? (Select all that apply.)

The nurse manager regularly rounds on staff to gather input on unit decisions. Signup and view all the answers

(Ch.21) A new nurse graduate is in orientation on a surgical unit and is being mentored by an experienced nurse. Which action completed by the new nurse graduate requires intervention by the experienced nurse? (Select all that apply.)

The new nurse stops documenting about a dressing change to take a patient some water. Signup and view all the answers

(Ch.24) When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.)

Check for needed adaptive equipment. Signup and view all the answers

(Ch.24) A patient has gone through a number of treatment changes during a shift of care. During the hand-off report, the nurse plans to communicate effectively with the nurse who will be caring next for the patient for which of the following reasons? (Select all that apply.)

To reduce the risk of errors to the patient Signup and view all the answers

(Ch.24) A nurse is using motivational interviewing with a patient. What outcomes does the nurse expect? (Select all that apply.)

Gain an understanding of the patient’s health goals. Signup and view all the answers

(Ch.24) Which techniques demonstrate a therapeutic response to an adult patient who is anxious? (Select all that apply.)

Providing good eye contact Signup and view all the answers

(Ch.24) A patient states, “I don’t have confidence in my doctor. She looks so young.” What is the nurse’s therapeutic response?

Tell me more about your concern. Signup and view all the answers

(Ch.24) The nurse applying effective communication skills throughout the nursing process should: (Place the following interventions in the correct order.)

Validate health care needs through verbal discussion with the patient.

Compare actual and expected patient care outcomes with the patient.

Provide support through therapeutic communication techniques.

Complete a nursing history using verbal communication techniques.

4, 1, 3, 2 Signup and view all the answers

(Ch.24) A nurse works with a patient using therapeutic communication during all phases of the therapeutic relationship. Place the nurse’s statements in order according to these phases

The nurse states, “Let’s work on learning injection techniques.”

The nurse is mindful of biases and knowledge in working with the patient with B12 deficiency.

The nurse summarizes progress made during the nursing relationship.

After providing introductions, the nurse defines the scope and purpose of the nurse-patient relationship.

2, 4, 1, 3 Signup and view all the answers

(Ch.24) Which strategies should a nurse use to facilitate a safe transition of care during a patient’s transfer from the hospital to a skilled nursing facility? (Select all that apply.)

Collaboration between staff members from sending and receiving departments Signup and view all the answers

(Ch.24) What outcome demonstrates the effective use of silence as a therapeutic communication technique?

The patient perceives having gained insight into the issue after the conversation. Signup and view all the answers

(Ch.22) The nurse is caring for a patient who needs a liver transplant to survive. This patient has been out of work for several months, does not have health insurance, and cannot afford the procedure. Which of the following statements speaks to the ethical elements of this case?

The health care team should select a plan that considers the principle of justice as it pertains to the distribution of health care resources. Signup and view all the answers

(Ch.22) When designing a plan for pain management for a patient following surgery, the nurse assesses that the patient’s priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient’s priority is met. If the nurse’s actions are driven by respect for autonomy, what aspect of this scenario best demonstrates this action?

Asking the patient to establish the goal for pain control Signup and view all the answers

(Ch.22) The application of deontology does not always resolve an ethical problem. Which of the following statements best explains one of the limitations of deontology?

In a diverse community it can be difficult to find agreement on which principles or rules are most important. Signup and view all the answers

(Ch.22) The ethics of care suggests that ethical dilemmas can best be solved by attention to relationships. How does this differ from other approaches to ethical problems? (Select all that apply.) Ethics of care:

pays attention to the context in which caring occurs. Signup and view all the answers

(Ch.22) The following are steps in the process to help resolve an ethical problem. What is the best order of these steps to achieve resolution?

List all the possible actions that could be taken to resolve the problem.

Articulate a statement of the problem or dilemma that you are trying to resolve.

Develop and implement a plan to address the problem.

Gather all relevant information regarding the clinical, social, and spiritual aspects of the problem.

Take time to clarify values and identify the ethical elements, such as principles and key relationships involved.

Recognize that the problem requires ethics.

6, 4, 5, 2, 1, 3 Signup and view all the answers

(Ch.22) Which social media uses can be implemented with patients and families without violating confidentiality? (Select all that apply.)

Social media can be used to provide supportive information. Signup and view all the answers

(Ch.22) Resolution of an ethical problem involves discussion with the patient, the patient’s family, and participants from appropriate health care disciplines. Which statement best describes the role of the nurse in the resolution of ethical problems?

To articulate the nurse’s unique point of view, including knowledge based on clinical and psychosocial observations Signup and view all the answers

(Ch.22) Which statements reflect the difficulty that can occur for agreement on a common definition of the word quality when it comes to quality of life? (Select all that apply.)

Community values influence definitions of quality, and they are subject to change over time. Signup and view all the answers

(Ch.22) Which statements properly apply an ethical principle to justify access to health care? (Select all that apply.)

Access to health care reflects the commitment of society to principles of beneficence and justice. Signup and view all the answers

(CH 25)A nurse who works in an outpatient chemotherapy infusion center is assigned to the care of a 56y.o male patient who is receiving chemotherapy for colon cancer. This is the patient’s first clinic visit. The nurse reviews the patient’s medical record and sees a note about the patient receiving instruction on how chemotherapy treats can- cer, but the note doesnt summarize the patient’s response. The Dr makes a quick visit and tells the patient, “We will get your treatment started today and will be checking your blood each week for any problems.” The doctor leaves and the patient asks the nurse, “What are the blood tests for?” To determine this patient’s learning needs, what should the nurse assess? (Select all)

The patient’s behavior as the nurse interacts with him and the patient’s level of knowledge about chemotherapy effects Signup and view all the answers

(CH25)A nurse who works in an outpatient chemotherapy infusion center is assigned to the care of a 56y.o. male patient who is receiving chemotherapy for colon cancer. This is the patient’s first clinic visit. The nurse reviews the patient’s medical record and sees a note about the patient receiving instruction on how chemotherapy treats cancer; the note doesnt summarize the patient’s response. The nurse’s assessment reveals that the patient is motivated to learn more about his chemotherapy and is alert and currently feeling well. The nurse has prepared the first infusion, regulated it, and now takes time to begin instruction. Which teaching approaches are best suited for this situation?

Provide verbal one-on-one instruction, with the patient participating in selection of content. Signup and view all the answers

(CH25)A 26-year-old patient visits a medical clinic and asks a nurse to provide instruction on how to perform a breast self-examination. “My mom had cancer so I want to learn how.” Which domains are required to learn this skill? (Select all that apply.)

Cognitive domain Signup and view all the answers

(CH25)A patient suddenly experienced a severe headache with numbness and decreased movement in the left arm. An emergency brain scan confirmed a cerebral vessel clot. With a stroke confirmed, the emergency room physician consults with a neurosurgeon to schedule an emergent angiogram to remove the clot. Which teaching approach is most appropriate for explaining to the patient what to expect from the procedure?

Telling approach Signup and view all the answers

(CH25)A nurse is teaching an older-adult patient about ways to detect a melanoma. Which of the following are age-appropriate teaching techniques for this patient? (Select all that apply.)

Speak in a low tone. Signup and view all the answers

(CH25)A 55-year-old man has been in the hospital for over a week follow- ing surgical complications. The patient has had limited activity but is now ordered to begin a mobility program. The patient just re- turned from several diagnostic tests and tells the nurse he is feeling fatigued. The nurse prepares to instruct the patient on the mobility program protocol. Which of the following learning principles will likely be affected by this patient’s condition?

Readiness to learn Signup and view all the answers

(CH25)A patient recovering from open heart surgery is taught how to cough and deep breathe using a pillow to support or splint the chest incision. Following the teaching session, which of the following is the best way for the nurse to evaluate whether learning has taken place?

Return demonstration Signup and view all the answers

(CH25) Match the ACCESS model component with the nursing approach

Help patients feel culturally secure and able to maintain their cultural identity. = Safety Learn about the patient’s health beliefs and practices. = Assessment Become aware of your patient’s culture and your own cultural biases = Cultural Show respect by creating a caring rapport. = Establishment Signup and view all the answers

(CH25)Match the correct model term to the nursing approach

<h1>Be aware of how patients from diverse backgrounds perceive their care needs. = communication Remain aware of verbal and nonverbal responses. = sensitivity</h1> = Signup and view all the answers

(CH25)A nurse is preparing to teach a patient who has sleep apnea how to use a continuous positive airway pressure (CPAP) machine at night. Which action is most appropriate for the nurse to perform first?

Set mutual goals for the education session. Signup and view all the answers

(CH25)Which of the following scenarios demonstrate that patient learning has taken place? (Select all that apply.)

A patient describes how to set up a pill organizer for newly ordered medicines. Signup and view all the answers

(CH26)A nurse contacts the health care provider about a change in a patient’s condition and receives several new orders for the patient over the phone. When documenting telephone orders in the EHR, what should the nurse do?

“Read back” all telephone orders to the health care provider over the phone to verify all orders were heard, understood, and transcribed correctly before entering the orders in the EHR. Signup and view all the answers

(CH26)You are a nurse who is working in an agency that has recently implemented an EHR. Which of the following are acceptable practices for maintaining the security and confidentiality of EHR information? (Select all that apply.)

Using a strong password and changing your password frequently according to agency policy Signup and view all the answers

(CH26)When documenting an assessment of a patient’s cardiac system in an EHR, the nurse uses the computer mouse to select the “WNL” statement to document the following findings: “Heart sounds S1 & S2 auscultated. Heart rate between 80 and 100 beats/min, and regular. Denies chest pain.” This is an example of using which of the following documentation formats?

Charting by exception (CBE) Signup and view all the answers

(CH26)The nurse works at an agency where military time is used for documentation and needs to document that a patient was medicated for pain after midnight. Identify the correct military time to document medication administered at 12:05 a.m.

0005 Signup and view all the answers

(CH26)The nurse who works at the local health care agency is transferring a patient to an acute rehabilitation center in another town. To com- plete the transfer, information from the patient’s EHR must be printed and faxed to the acute rehabilitation center. Which of the following actions are appropriate for the nurse to take to maintain privacy and confidentiality of the patient’s information when faxing this information? (Select all that apply.)

Confirm that the fax number for the acute rehabilitation center is correct before sending the fax. Signup and view all the answers

(CH26)The nurse is administering a dose of metoprolol to a patient and is completing the steps of bar-code medication administration within the EHR. As the bar-code information on the medication is scanned, an alert that states, “Do not administer dose if apical heart rate (HR) is ,60 beats/min or systolic blood pressure (SBP) is ,90 mm Hg” appears on the computer screen. The alert that appeared on the computer screen is an example of what type of system?

Clinical decision support system(CDSS) Signup and view all the answers

(CH26)The nurse is writing a narrative progress note. Identify each of the following statements as subjective data (S) or objective data (O):

April 24, 2021 (0900) = O Repositioned patient on left side. = O Medicated with hydrocodone-acetaminophen 5/325 mg, 2 tablets PO. = O “The pain in my incision increases every time I try to turn on my right side.” = S Signup and view all the answers

(CH26)The nurse is writing a narrative progress note. Identify each of the following statements as subjective data (S) or objective data (O):

<h1>S.Eastman,RN = O Surgical incision right lower quadrant ,3 inches in length, well approximated, sutures intact, no drainage. = O Rates pain 7/10 at location of surgical incision. = O</h1> Signup and view all the answers

(CH26)The nurse is discussing the advantages of using CPOE with a nursing colleague. Which statement best describes the major advantage of a CPOE system within an EHR?

CPOE improves patient safety by reducing transcription errors. Signup and view all the answers

(CH26)The nurse is reviewing health care provider orders that were handwritten on paper when all computers were down during a system upgrade. Which of the following orders contains an inappropriate abbreviation included on TJC’s “do not use” list and should be clarified with the health care provider?

Insulin aspart 8u SQ every morning before breakfast Signup and view all the answers

(CH26)The nurse is changing the dressing over the midline incision of a patient who had surgery. Assessment of the incision reveals changes from what was documented by the previous nurse. After documenting the current wound assessment, the nurse contacts the surgeon by telephone to discuss changes in the incision that are of concern. Which of the following illustrates the most ap- propriate way for the nurse to document this conversation?

09-3-21 (1015): Surgeon contacted by phone. Notified about new area of bright red erythema extending approximately 1 inch around circumference of midline abdominal incision and oral temperature of 101.5 F. No orders received. T. Wright, RN Signup and view all the answers

(Ch.15) Match the concepts for a critical thinker on the left with the application of the term on the right,

Truth seeking = Be objective in asking patient questions. Open-mindedness = Be tolerant of the patient’s views and beliefs. Analyticity = Anticipate how a patient might respond to a treatment. Systematicity = Organize assessment on the basis of patient priorities. Signup and view all the answers

(Ch.24) A nurse prepares to contact a patient’s health care provider about a change in the patient’s condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication.

Background = “She is a 53-year-old woman who was admitted 2 days ago with pneumonia and was started on levofloxacin at 5 p.m. yesterday. She states she has a poor appetite; her weight has remained stable over the past 2 days.” Assessment = “The patient reported feeling very nauseated after her dose of levofloxacin an hour ago.” Recommendation = “Is it possible to make a change in antibiotics, or could we give her a nutritional supplement before her medication?” Situation = “The patient started to complain of nausea yesterday evening and vomited several times during the night.” Signup and view all the answers

(Ch.22) Match the following actions with the terms listed below:

You see an open medical record on the computer and close it so that no one else can read the record without proper access. = Confidentiality You administer a once-a-day cardiac medication at the wrong time, but nobody sees it. However, you contact the provider and your nurse manager and follow agency procedure. = Accountability A patient at the end of life wants to go home to die, but the family wants every care possible. The nurse contacts the primary care provider about the patient’s request. = Advocacy You tell your patient that you will return in 30 minutes to give him his next pain medication. = Responsibility Signup and view all the answers

JoAnn, a nurse, is calling a patient’s health care provider about a problem that her patient, Ms. Ducote, is having during a blood transfusion. The health care agency uses the SBAR system in reporting patient problems. Put the statements in the correct order according to the SBAR system.

I think she might need a diuretic ordered. Is it possible for you to come see her soon? Is there anything else you would like for me to do right now? = Recommendation This is JoAnn. I am caring for Ms. Ducote. She is having labored breathing and her heart rate is higher now than it was an hour ago. She is receiving the second unit of her blood transfusion. She says she is having trouble catching her breath. = Situation Ms. Ducote had surgery earlier yesterday to remove a tumor in the colon. Her hemoglobin was 9.6 grams/dL, and her hema- tocrit was 33.6% this morning. Her first ordered unit of packed red blood cells infused over 90 minutes, and she is 30 minutes into receiving her second unit of blood now. She states she takes furosemide 20 mg every morning at home. She does not currently have an order for furosemide. = Background The patient denies pain, and her vital signs are as follows: B/P 150/98 mm Hg; pulse 118; respiratory rate 28; temperature 98.8° F (37.1° C). I think she is showing signs of fluid volume overload. = Assessment Signup and view all the answers

Study Notes

Clinical Decision Making

A nurse's ability to make clinical decisions is improved by:
- Knowing the patient
- Seeking truth and finding possible solutions
- Being open-minded and non-judgmental
- Being analytical and systematic
- Focusing on the patient's values and beliefs
The REFLECT model improves learning after providing patient care:
1. Think about thoughts and actions at the time of the situation
2. Review the knowledge gained from the experience
3. Review the facts of the situation
4. Set a schedule for completing the plan of action
5. Consider options for handling a similar situation in the future
6. Recall feelings at the time of the situation
7. Create a plan for future situations
A nurse's ability to know patients better is affected by:
- Assessing the patient's behavior and attitude
- Focusing on the patient's values and beliefs
- Seeking feedback from the patient

Critical Thinking

Critical thinking attitudes:
- Seeking truth and finding possible solutions
- Being open-minded and non-judgmental
- Being analytical and systematic
- Focusing on the patient's values and beliefs
Critical thinking standards:
- Truth seeking
- Open-mindedness
- Analyticity
- Systematicity
A nurse uses critical thinking by:
- Assessing the patient's situation and identifying possible solutions
- Evaluating the patient's data and making a thoughtful decision

Delegation

The Five Rights of Delegation:
- Right task
- Right person
- Right direction
- Right supervision
- Right evaluation
A nurse delegates a task to an assistive personnel (AP) by:
- Providing clear instructions
- Providing the necessary resources
- Ensuring the AP understands the task
- Supervising and evaluating the task

Communication

SBAR (Situation, Background, Assessment, and Recommendation) communication:
1. Situation
2. Background
3. Assessment
4. Recommendation
Effective communication:
- Uses active listening
- Uses clear and concise language
- Focuses on the patient's needs
- Uses nonverbal cues
Therapeutic communication:
- Uses empathy and understanding
- Focuses on the patient's feelings
- Uses open-ended questions
- Encourages the patient to express themselves

Ethical Decision Making

Ethical principles:
- Autonomy
- Beneficence
- Nonmaleficence
- Justice
Deontology:
- Focuses on the moral rules and principles
- Emphasizes the importance of duty and obligation
Ethics of care:
- Focuses on the relationships and care for others
- Emphasizes the importance of empathy and compassion
Steps to resolve an ethical problem:
1. Articulate the problem
2. Gather relevant information
3. Identify the ethical elements
4. Develop and implement a plan
5. Evaluate the outcome

Teaching and Learning

The nurse assesses the patient's learning needs by:
- Identifying the patient's priorities
- Assessing the patient's knowledge and understanding
- Evaluating the patient's response to teaching
Teaching approaches:
- Lecture
- Demonstration
- Return demonstration
- Discussion
Learning principles:
- Focus on the patient's needs
- Use clear and concise language
- Use active learning
- Use reinforcement and feedback

Electronic Health Records (EHRs)

EHRs:
- Improve patient safety
- Improve communication
- Increase efficiency
- Reduce errors
Accessing and maintaining EHRs:
- Use passwords and authentication
- Use secure networks and systems
- Limit access to authorized personnel
- Use audit trails and logs
Documenting in EHRs:
- Use clear and concise language
- Use standardized formats and templates
- Use accurate and complete information
- Use electronic signatures and authentication

Studying That Suits You

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Description

Identify the patient/population component in a research question. Practice critical thinking and comprehension in research methodology. Evaluate the effectiveness of guided imagery on post-operative pain in adolescents.

Chapters: 15, 21, 24, 22, 25, 26

Questions and Answers

(Ch.15) One element of clinical decision making is knowing the patient. Which of the following activities affect a nurse’s ability to know patients better? (Select all that apply.)

(Ch.15) A nurse is giving a patient a medication and notices the dosage. From the nurse’s experience, the dosage is higher than what is normally given. Which of the following steps should the nurse take to ensure a safe outcome for the patient? (Select all that apply.)

(Ch.21) A nurse received change-of-shift reports on these four patients and starts rounding. Which patient does the nurse need to focus on as a priority?

(Ch.21) While administering medications, a nurse realizes that a prescribed dose of a medication was not given. The nurse acts by completing an incident report and notifying the patient’s health care provider. Which of the following is the nurse exercising?

(Ch.21) Which task is appropriate for a registered nurse (RN) to delegate to an AP?

(Ch.21) Which example demonstrates a nurse performing the skill of evaluation?

(Ch.21) The nurse manager from the surgical unit was awarded the nursing leadership award for practice of transformational leadership. Which of the following are characteristics or traits of transformational leadership displayed by the award winner? (Select all that apply.)

(Ch.21) A new nurse graduate is in orientation on a surgical unit and is being mentored by an experienced nurse. Which action completed by the new nurse graduate requires intervention by the experienced nurse? (Select all that apply.)

(Ch.24) When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.)

(Ch.24) A patient has gone through a number of treatment changes during a shift of care. During the hand-off report, the nurse plans to communicate effectively with the nurse who will be caring next for the patient for which of the following reasons? (Select all that apply.)

(Ch.24) A nurse is using motivational interviewing with a patient. What outcomes does the nurse expect? (Select all that apply.)

(Ch.24) Which techniques demonstrate a therapeutic response to an adult patient who is anxious? (Select all that apply.)

(Ch.24) A patient states, “I don’t have confidence in my doctor. She looks so young.” What is the nurse’s therapeutic response?

(Ch.24) Which strategies should a nurse use to facilitate a safe transition of care during a patient’s transfer from the hospital to a skilled nursing facility? (Select all that apply.)

(Ch.24) What outcome demonstrates the effective use of silence as a therapeutic communication technique?

(Ch.22) The nurse is caring for a patient who needs a liver transplant to survive. This patient has been out of work for several months, does not have health insurance, and cannot afford the procedure. Which of the following statements speaks to the ethical elements of this case?

(Ch.22) The application of deontology does not always resolve an ethical problem. Which of the following statements best explains one of the limitations of deontology?

(Ch.22) The ethics of care suggests that ethical dilemmas can best be solved by attention to relationships. How does this differ from other approaches to ethical problems? (Select all that apply.) Ethics of care:

(Ch.22) Which social media uses can be implemented with patients and families without violating confidentiality? (Select all that apply.)

(Ch.22) Resolution of an ethical problem involves discussion with the patient, the patient’s family, and participants from appropriate health care disciplines. Which statement best describes the role of the nurse in the resolution of ethical problems?

(Ch.22) Which statements reflect the difficulty that can occur for agreement on a common definition of the word quality when it comes to quality of life? (Select all that apply.)

(Ch.22) Which statements properly apply an ethical principle to justify access to health care? (Select all that apply.)

(CH25)A 26-year-old patient visits a medical clinic and asks a nurse to provide instruction on how to perform a breast self-examination. “My mom had cancer so I want to learn how.” Which domains are required to learn this skill? (Select all that apply.)

(CH25)A nurse is teaching an older-adult patient about ways to detect a melanoma. Which of the following are age-appropriate teaching techniques for this patient? (Select all that apply.)

(CH25)A patient recovering from open heart surgery is taught how to cough and deep breathe using a pillow to support or splint the chest incision. Following the teaching session, which of the following is the best way for the nurse to evaluate whether learning has taken place?

(CH25) Match the ACCESS model component with the nursing approach

(CH25)Match the correct model term to the nursing approach

(CH25)A nurse is preparing to teach a patient who has sleep apnea how to use a continuous positive airway pressure (CPAP) machine at night. Which action is most appropriate for the nurse to perform first?

(CH25)Which of the following scenarios demonstrate that patient learning has taken place? (Select all that apply.)

(CH26)A nurse contacts the health care provider about a change in a patient’s condition and receives several new orders for the patient over the phone. When documenting telephone orders in the EHR, what should the nurse do?

(CH26)You are a nurse who is working in an agency that has recently implemented an EHR. Which of the following are acceptable practices for maintaining the security and confidentiality of EHR information? (Select all that apply.)

(CH26)The nurse works at an agency where military time is used for documentation and needs to document that a patient was medicated for pain after midnight. Identify the correct military time to document medication administered at 12:05 a.m.

(CH26)The nurse is writing a narrative progress note. Identify each of the following statements as subjective data (S) or objective data (O):

(CH26)The nurse is writing a narrative progress note. Identify each of the following statements as subjective data (S) or objective data (O):

(CH26)The nurse is discussing the advantages of using CPOE with a nursing colleague. Which statement best describes the major advantage of a CPOE system within an EHR?

(Ch.15) Match the concepts for a critical thinker on the left with the application of the term on the right,

(Ch.24) A nurse prepares to contact a patient’s health care provider about a change in the patient’s condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication.

(Ch.22) Match the following actions with the terms listed below:

JoAnn, a nurse, is calling a patient’s health care provider about a problem that her patient, Ms. Ducote, is having during a blood transfusion. The health care agency uses the SBAR system in reporting patient problems. Put the statements in the correct order according to the SBAR system.

Study Notes

Clinical Decision Making

Critical Thinking

Delegation

Communication

Ethical Decision Making

Teaching and Learning

Electronic Health Records (EHRs)

Studying That Suits You

Description

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