You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nu
Defines the principles of right and wrong to provide patient care
An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of pract
A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed?
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family an
The nurse spends time with the patient and family reviewing the dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role?
Which activity performed by a nurse is related to maintaining competency in nursing practice?
1.) Asking another nurse about how to change the settings on a medication pump
2.) Regularly attending unit staff meetings
3.) Participating as a member of the p
Attending a review course in preparation for a certification examination
Which of the following are examples of a nurse participating in primary care activities? (Select all that apply.)
1.) Providing prenatal teaching on nutrition to a pregnant woman during the first trimester
2.) Assessing the nutritional status of older adu
Providing prenatal teaching on nutrition to a pregnant woman during the first trimester
Assessing the nutritional status of older adults who come to the community center for lunch
Teaching a class to parents at the local grade school about the importance
Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system?
Which of the following nursing activities is provided in a secondary health care environment?
1.) Conducting blood pressure screenings for older adults at the Senior Center
2.) Teaching a clinic patient with chronic obstructive pulmonary disease purse-lip
A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care?
1.) Patient will be able to walk 200 feet without shortness of breath.
Patient will be able to walk 200 feet without shortness of breath.
A nurse is presenting a program to workers in a factory covering safety topics, including the wearing of hearing protectors when workers are in the factory. Which level of prevention is the nurse practicing?
1.) Primary prevention
2.) Secondary prevention
A patient had surgery for a total knee replacement a week ago and is currently participating in daily physical rehabilitation sessions at the surgeon's office. In what level of prevention is the patient participating?
1.) Primary prevention
Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: "Me, stop smoking? I've been smoking since I was 16!"
1.) "That's fine. Some people who smoke live a long life."
2.) "OK. I want you to decrease
I understand. Can you think of the greatest reason why stopping smoking would be challenging for you?
A patient comes to the local health clinic and states: "I've noticed how many people are out walking in my neighborhood. Is walking good for you?" What is the best response to help the patient through the stages of change for exercise?
1.) "Walking is OK.
Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?
A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been seeing his pastor to help him through this difficult time. He does not have a primary health car
Difficulty paying his bills
family practice of not routinely seeing a health care provider
A nurse is conducting a home visit with an older-adult couple. While in the home the nurse weighs each individual and reviews the 3-day food diary with them. She also checks their blood pressure and encourages them to increase their fluids and activity le
When taking care of patients, a nurse routinely asks if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important
A couple who is caring for their aging parents are concerned about factors that put them at risk for falls. Which factors are most likely to contribute to an increase in falls in the elderly? (Select all that apply.)
1.) Inadequate lighting
2.) Throw rugs
Cords covered by carpets
You are caring for a patient who frequently tries to remove his intravenous catheter and feeding tube. You have an order from the health care provider to apply a wrist restraint. Place the steps for applying a wrist restraint in the correct order.
1.) Identify patient using 2 identifiers
2.) introduce self & ask patient about his feelings of being restrained
3.) be sure that patient is comfortable with arm in anatomical alignment
4.) assess condition of skin where restraint will be placed
The family of a patient who is confused and ambulatory insists that all four side rails be up when the patient is alone. What is the best action to take in this situation? (Select all that apply.)
1.) Contact the nursing supervisor.
2.) Restrict the famil
Ask the family to stay with the patient if possible.
Inform the family of the risks associated with side-rail use.
Discuss alternatives that are appropriate for this patient with the family.
You are conducting an education class at a local senior center on safe-driving tips for seniors. Which of the following should you include? (Select all that apply.)
1.) Drive shorter distances
2.) Drive only during daylight hours
3.) Use the side and rear
Drive shorter distances
Drive only during daylight hours
Use the side and rearview mirrors carefully
Keep a window rolled down while driving if has trouble hearing
Look behind toward the blind spot
The nursing assessment of an 80-year-old patient who demonstrates some confusion but no anxiety reveals that the patient is a fall risk because she continues to get out of bed without help despite frequent reminders. The initial nursing intervention to pr
Place a bed alarm device on the bed
A nurse is evaluating a patient who is in soft wrist restraints. Which of the following activities does the nurse perform? (Select all that apply.)
1.) Check the patient's peripheral pulse in the restrained extremity
2.) Evaluate the patient's need for to
Check the patient's peripheral pulse in the restrained extremity
Evaluate the patient's need for toileting
Offer the patient fluids if appropriate
Inspect the skin under each restraint
You are admitting Mr. Jones, a 64-year-old patient who had a right hemisphere stroke and a recent fall. His wife stated that he has a history of high blood pressure, which is controlled by an antihypertensive and a diuretic. Currently he exhibits left-sid
Smokes a pack a day
Takes antihypertensive and diuretics
What is the most effective way to control transmission of infection?
1.) Isolation precautions
2.) Identifying the infectious agent
3.) Hand hygiene practices
Hand hygiene practices
A patient who has been isolated for Clostridium difficile (C. difficile) asks you to explain what he should know about this organism. What is the most appropriate information to include in patient teaching? (Select all that apply.)
1.) The organism is usu
The organism is usually transmitted through the fecal-oral route.
Hands should always be cleaned with soap and water versus alcohol-based hand sanitizer.
Everyone coming into the room must be wearing a gown and gloves.
A patient is diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Which type of isolation precaution is most appropriate for this patient?
1.) Reverse isolation
2.) Droplet precautions
3.) Standard precautions
4.) Contact precautio
A family member is providing care to a loved one who has an infected leg wound. What should the nurse instruct the family member to do after providing care and handling contaminated equipment or organic material?
1.) Wear gloves before eating or handling
Perform hand hygiene after care and/or handling contaminated equipment or material.
A patient is isolated for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. Which is the best intervention?
1.) Provide a dark, quiet room to calm the patient.
When should a nurse wear a mask? (Select all that apply.)
1.) The patient's dental hygiene is poor.
2.) The nurse is assisting with an aerosolizing respiratory procedure such as suctioning.
3.) The patient has acquired immunodeficiency syndrome (AIDS) and
The nurse is assisting with an aerosolizing respiratory procedure such as suctioning.
The patient has acquired immunodeficiency syndrome (AIDS) and a congested cough.
The patient is in droplet precautions.
The nurse is assisting a health care provider in
Which type of personal protective equipment are staff required to wear when caring for a pediatric patient who is placed into airborne precautions for confirmed chickenpox/herpes zoster? (Select all that apply.)
1.) Disposable gown
2.) N 95 respirator mas
N 95 respirator mask
Face shield or goggles
The infection control nurse has asked the staff to work on reducing the number of iatrogenic infections on the unit. Which of the following actions on your part would contribute to reducing health care-acquired infections? (Select all that apply.)
Teaching correct hand washing to assigned patients
A patient has an indwelling urinary catheter. Why does an indwelling urinary catheter present a risk for urinary tract infection? (Select all that apply.)
1.) It allows migration of organisms into the bladder.
2.) The insertion procedure is not done under
It allows migration of organisms into the bladder.
It obstructs the normal flushing action of urine flow.
Put the following steps for removal of protective barriers after leaving an isolation room in order.
1.) Remove gloves.
2.) Perform hand hygiene.
3.) Remove eyewear or goggles
4.) Untie top and then bottom mask strings and remove from face.
5.) Untie wais
1.) remove gloves
2.) remove eyewear/goggles
3.) Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side
4.) untie top and then bottom mask strings and remove from face
5.) perform hand hygiene
A 52-year-old woman is admitted with dyspnea and discomfort in her left chest with deep breaths. She has smoked for 35 years and recently lost over 10 lbs. Her vital signs on admission are: HR 112, BP 138/82, RR 22, tympanic temperature 36.8� C (98.2� F),
Oxygen saturation: 96%
The licensed practical nurse (LPN) provides you with the change-of-shift vital signs on four of your patients. Which patient do you need to assess first?
1.) 84-year-old man recently admitted with pneumonia, RR 28, SpO2 89%
2.) 54-year-old woman admitted
84-year-old man recently admitted with pneumonia, RR 28, SpO2 89%
As you are obtaining the oxygen saturation on a 19-year-old college student with severe asthma, you note that she has black nail polish on her nails. You remove the polish from one nail, and she asks you why her nail polish had to be removed. What is the
Nail polish interferes with sensor function
A patient presents in the clinic with dizziness and fatigue. The nursing assistant reports a slow but regular radial pulse of 44. What is your priority intervention?
1.) Request that the nursing assistant repeat the pulse check
2.) Call for a stat electro
Assess the patients apical pulse and evidence of a pulse deficit
Which patient is at highest risk for tachycardia?
1.) A healthy basketball player during warmup exercises
2.) A patient admitted with hypothermia
3.) A patient with a fever of 39.4� C (103� F)
4.) A 90-year-old male taking beta blockers
A patient with a fever of 39.4� C (103� F)
Which of the following patients are at most risk for tachypnea? (Select all that apply.)
1.) Patient just admitted with four rib fractures
2.) Woman who is 9 months' pregnant
3.) Adult who has consumed alcoholic beverages
4.) Adolescent waking from sleep
Patient just admitted with four rib fractures
Woman who is 9 months' pregnant
3 pack per day smoker with pneumonia
A healthy adult patient tells the nurse that he obtained his blood pressure in "one of those quick machines in the mall" and was alarmed that it was 152/72 when his normal value ranges from 114/72 to 118/78. The nurse obtains a blood pressure of 116/76. W
Cuff too small
insufficient time between measurements
A patient is admitted for dehydration caused by pneumonia and shortness of breath. He has a history of heart disease and cardiac dysrhythmias. The nursing assistant reports his admitting vital signs to the nurse. Which measurements should the nurse reasse
Radial pulse rate: 72 and irregular
Respiratory rate: 28
Oxygen saturation: 99%
The nurse prepares to conduct a general survey on an adult patient. Which assessment is performed first while the nurse initiates the nurse-patient relationship?
1.) Appearance and behavior
2.) Measurement of vital signs
3.) Observing specific body system
Conducting a detailed health history
The nurse is performing an abdominal assessment on a patient. In what order does the nurse perform the steps?
The nurse is assessing a patient who returned 1 hour ago from surgery for an abdominal hysterectomy. Which assessment finding would require immediate follow-up?
1.) Auscultation of an apical heart rate of 76
2.) Absence of bowel sounds on abdominal assess
Respiratory rate of 8 breaths/min
Which of the following are considered social determinants of health? (Select all that apply.)
1.) Lack of primary health care providers in a zip code
2.) Poor-quality public school education that prevents a person from developing adequate reading skills
Lack of primary health care providers in a zip code
Poor-quality public school education that prevents a person from developing adequate reading skills
Lack of affordable health insurance
Employment opportunities that do not provide paid vacation or sick
Which of the following are examples of problems with the health care system that contribute to health disparities? (Select all that apply.)
1.) A health care provider assumes that the patient missed two appointments because the patient does not care about
A health care provider assumes that the patient missed two appointments because the patient does not care about his or her health and does not inquire about the reasons for missed visits.
A community hospital lacks an adequate staff of social workers who
A patient is admitted through the emergency department (ED) after a serious car accident. The nurse assesses the patient and quickly learns that he speaks little English. Spanish is his primary language. The nurse speaks some Spanish. Which interventions
The nurse requests a professional interpreter.
The nurse determines the interpreter's qualifications and makes sure that the interpreter can speak the patient's dialect.
The nurse uses short sentences to explain the treatments provided in the ED.
A new nurse is caring for a hospitalized obese patient who is homeless. This is the first time the patient has been admitted to the hospital, and the patient is scheduled for surgery. Which of the following is a universal skill that will help the nurse wo
The nurse asks the patient, "Tell me about the main problems you have had with your health from not having a home.
Which statement made by a new graduate nurse about the teach-back technique requires intervention and further instruction by the nurse's preceptor?
1.) "After teaching a patient how to use an inhaler, I need to use the Teach Back technique to test my pati
After teaching a patient how to use an inhaler, I need to use the Teach Back technique to test my patient's understanding.
How can a nurse work on developing cultural awareness? (Select all that apply.)
1.) Reflect on his or her past learning about health, illness, race, gender, and sexual orientation
2.) Develop greater self-knowledge about personal biases
3.) Recognize cons
Reflect on his or her past learning about health, illness, race, gender, and sexual orientation
Develop greater self-knowledge about personal biases
Recognize consciously the multiple factors that influence his or her own world view
Engage in an in-depth
During an encounter with an elderly patient, the nurse recognizes that a thorough cultural assessment is necessary because the patient has recently come to the United States from Russia and has never been hospitalized before. The nurse wants to discuss cu
When you care for a patient who does not speak English, it is necessary to call on a professional interpreter. Which of the following are proper principles for working with interpreters? (Select all that apply.)
1.) Expect the interpreter to interpret you
If you feel an interpretation is not correct, stop and address the situation directly with the interpreter.
Pace a conversation so there is time for the patient's response to be interpreted.
Direct your questions to the interpreter.
Ask the patient for fe
When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.)
1.) Check for needed adaptive equipment.
2.) Exaggerate lip movements to help the patient lip read.
3.) Give the pa
Check for needed adaptive equipment.
Give the patient time to respond to questions.
Keep communication short and to the point.
Nurses must communicate effectively with the health care team for which of the following reasons? (Select all that apply.)
1.) Improve the nurse's status with the health team members
2.) Reduce the risk of errors to the patient
3.) Provide optimum level o
A new nurse complains to her preceptor that she has no time for therapeutic communication with her patients. Which of the following is the best strategy to help the nurse find more time for this communication?
1.) Include communication while performing ta
Include communication while performing tasks such as changing dressings and checking vital signs.
A nurse is talking with a young-adult patient about the purpose of a new medication. The nurse says, "I want to be clear. Can you tell me in your words the purpose of this medicine?" This exchange 334is an example of which element of the transactional com
A patient who is Spanish-speaking does not appear to understand the nurse's information on wound care. Which action should the nurse take?
1.) Arrange for a Spanish-speaking social worker to explain the procedure
2.) Ask a fellow Spanish-speaking patient
Use a professional interpreter to provide wound care education in Spanish
A nurse is assigned to care for a patient for the first time and states, "I don't know a lot about your culture and want to learn how to better meet your health care needs." Which therapeutic communication technique did the nurse use in this situation?
A nurse has been gathering physical assessment data on a patient and is now listening to the patient's concerns. The nurse sets a goal of care that incorporates the patient's desire to make treatment decisions. This is an example of the nurse engaged in w
A patient is evaluated in the emergency department after causing an automobile accident while being under the influence of alcohol. While assessing the patient, which statement would be the most therapeutic?
1.) "Why did you drive after you had been drink
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.)
1.) Collaboration between staff members from sending and receiving department
Collaboration between staff members from sending and receiving departments
Using a standardized transfer policy and transfer tool
A nurse is explaining to a patient how to follow infection control practices at home. During the discussion the nurse touches the patient on the shoulder. Explain which zone of touch the nurse should be practicing and what problems the action might cause.
The nurse uses silence as a therapeutic communication technique. What is the purpose of the nurse's silence? (Select all that apply.)
1.) Prevent the nurse from saying the wrong thing
2.) Prompt the patient to talk when he or she is ready
3.) Allow the pa
Prompt the patient to talk when he or she is ready
Allow the patient time to think and gain insight