N50 2nd review

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Week 3: Taylor: 1,3,5,24 Brunner: 11,4 Gerontology: 1,5 ATI: 16,25,34,35 for week 4: Taylor: 11,18,19 Brunner: 2,5,11,43,47,48 ATI 43,44

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1
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Ch 1:

A nurse is planning education for a patient who is scheduled for a diagnostic procedure to rule out a cerebral aneurysm. Which aspect of nursing does the nurse use as the basis for education?

a. Art of nursing

b. Science of nursing

c. Caring aspect of nursing

d. Holistic approach to nursing

b. Science of nursing

2
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A group of students in a community health course is discussing disaster management. Which nursing leader will the students identify as the founder of the Red Cross?

a. Clara Barton

b. Florence Nightingale

c. Lillian Wald

d. Lavinia Dock

a. Clara Barton

3
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A nurse is engaged in community health promotion activities. What activity best reflects this type of health promotion?

a. Teaching about fall prevention and home safety at a senior center

b. Holding a blood glucose screening for diabetes at a local church

c. Educating hospice volunteers on therapeutic communication

d. Providing education on crutch walking to a child with a fractured tibia

a. Teaching about fall prevention and home safety at a senior center

4
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A nurse historian is researching changes in professional nursing and nursing education in the mid-20th century. What trend promoted advancement of the profession and of nursing education?

a. Increased need for nurses and knowledge explosion led to emphasis on education. '

b. Focus on the war effort slowed development of knowledge in medicine and technology.

c. Role of the nurse focused on acute technical skills used in hospital settings.

d. Nursing care was dependent on the medical profession to define its priorities.

a. Increased need for nurses and knowledge explosion led to emphasis on education.

5
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According to Nursing: Scope and Standards of Practice (ANA, 2021), “Nursing is the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations in recognition of the connection of all humanity. Which actions are consistent with these nursing roles? Select all that apply.

a. Offering emotional support to a patient overwhelmed by a new diagnosis of ovarian cancer

b. Making a diagnosis of appendicitis when a patient reports right lower quadrant pain

c. Providing classes on nutrition and physical activity at a senior center

d. Administering an antibiotic to a patient with a documented infection

e. Working with the health department to provide free influenza vaccinations to children

f. Requesting the health care provider change prescription for the patient whose pain is still unrelieved

a. Offering emotional support to a patient overwhelmed by a new diagnosis of ovarian cancer

c. Providing classes on nutrition and physical activity at a senior center

d. Administering an antibiotic to a patient with a documented infection

e. Working with the health department to provide free influenza vaccinations to children

f. Requesting the health care provider change prescription for the patient whose pain is still unrelieved

6
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A nurse working in a rehabilitation facility focuses on the goal of restoring health for patients. Which nursing interventions could the nurse use to meet this goal? Select all that apply.

a. Counseling adolescents in a drug rehabilitation program

b. Performing range-of-motion exercises for a patient on bedrest

c. Demonstrating insulin injection to a patient with diabetes

d. Recommending a yoga class for a busy executive

e. Providing hospice care for a patient with end-stage cancer

f. Teaching a nutrition class at a local high school

a. Counseling adolescents in a drug rehabilitation program

b. Performing range-of-motion exercises for a patient on bedrest

c. Demonstrating insulin injection to a patient with diabetes

7
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Nursing students are learning about the criteria that establish nursing as a profession. Which statements by the students indicate they have correctly described characteristics of a profession? Select all that apply.

a. Nursing is composed of a well-defined body of general knowledge.

b. Nursing interventions are dependent upon medical practice.

c. Nursing is a recognized authority by a professional group.

d. Nursing practice is regulated by the medical profession.

e. Nursing has a code of ethics.

f. Nursing is influenced by ongoing research.

c. Nursing is a recognized authority by a professional group.

e. Nursing has a code of ethics.

f. Nursing is influenced by ongoing research.

8
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A nurse considers returning to school to obtain a master’s degree in nursing. Which practice discipline requiring graduate level education could the nurse consider?

a. Rehabilitation nurse

b. Critical care nurse

c. Oncology nurse

d. Nurse practitioner

d. Nurse practitioner

9
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Nurses in the United States follow regulations outlined by each state’s nurse practice act. A nurse moving to a different state anticipates finding which elements are common to all states’ nurse practice acts?

a. Definition of the legal scope of nursing practice for those registered

b. Provision of continuing education programs to meet state requirements

c. Determining the scope of content covered in the NCLEX examination

d. Creating institutional policies for health care practices

a. Definition of the legal scope of nursing practice for those registered

10
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Nurses of a statewide nursing organization come together to plan for the challenges to health care for the 21st century. What current trend in health care should be a focus of the plan?

a. Decreasing numbers of hospitalized patients

b. Increasing numbers of older and more acutely ill patients

c. Decreasing health care costs owing to managed care

d. Decreasing advances in medical knowledge and technology

b. Increasing numbers of older and more acutely ill patients

11
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A nurse in a health clinic is caring for a 21-year-old client who tells the nurse that their last physical exam was in high school. Which of the following health screenings should the nurse expect the provider to perform for this client?

a. testicular examination

b. blood glucose

c. fecal occult blood

d. prostate specific antigen

a. testicular examination

b,c is for 45+

d is for 55+

12
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A nurse at a provider’s office is talking about routine screenings with a 45-year-old female client who has no specific family history of cancer or diabetes mellitus. Which of the following client statements indicates that the client understands how to proceed?

a. “I’ll need a colonoscopy in 5 years.”

b. “For now, I should continue to have a clinical breast exam each year.”

c. “Because the doctor just did a Pap smear, I’ll come back next year for another one.”

d. “I had by blood glucose tested last year, so I won’t need it again for the next 4 years.”

b. “For now, I should continue to have a clinical breast exam each year.”

13
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Preventions

Primary: Protection

Secondary: Screening; acute treatment

Tertiary: Long Term Treatment

14
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A nurse is caring for a young adult at a college health clinic. Which of the following actions should the nurse take first?

a. Give the client information about immunization against meningitis.

b. Tell the client to have a TB skin test every 2 years.

c. Determine the client’s health risks.

d. Teach the client about exercise recommendations.

c. Determine the client’s health risks.

15
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A nurse at a health department is planning strategies related to heart disease. Which of the following activities should the nurse include as part of primary prevention?

a. providing cholesterol screening

b. teaching about a healthy diet

c. providing information about antihypertensive medications

d. developing a list of cardiac rehabilitation programs

b. teaching about a healthy diet

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A nurse in a clinic is planning health promotion and disease prevention strategies for a client who has multiple risk factors for cardiovascular disease. Which of the following interventions should the nurse include?

a. Help the client see the benefits of their actions

b. Identify the client’s support system

c. Suggest and recommend community resources

d. Devise and set goal for client

e. Teach stress management strategies

a. Help the client see the benefits of their actions

b. Identify the client’s support system

c. Suggest and recommend community resources

e. Teach stress management strategies

17
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A nurse is obtaining a health history from an older adult client as part of a comprehensive physical exam. Which of the following findings should the nurse expect as associated with aging?

a. skin thickening

b. decreased height

c. increased saliva production

d. nail thickening

e. decreased bladder capacity

b. decreased height

d. nail thickening

e. decreased bladder capacity

18
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A nurse is counseling an older adult who describes having difficulty dealing with several issues. Which of the following problems verbalized by the client should the nurse identify as the priority?

a. “I spent my whole life dreaming about retirement and now I wish I had my job back.”

b. “It’s been so stressful for me to have to depend on my child to help around the house.”

c. “I just heard my friend AI died. That’s the third one in 3 months.”

d. “I keep forgetting which medications I have taken during the day.”

d. “I keep forgetting which medications I have taken during the day.”

19
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A nurse is planning a presentation for a group of older adults about health promotion and disease prevention. Which of the following should the nurse plan to include in the presentation?

a. Human papilloma virus (HPV) immunization

b. Pneumococcal vaccination

c. Yearly eye examination

d. Periodic mental health screening

e. Annual fetal occult blood test

b. Pneumococcal vaccination

c. Yearly eye examination

d. Periodic mental health screening

e. Annual fetal occult blood test

20
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A nurse is providing teaching for an older adult client who has lost 4.5kg (9.9lb) since the last admission 6 months ago. Which of the following instructions should the nurse include in the teaching?

a. “ Eat three large meals a day”

b. “Eat you meals in front of the television.”

c. “Eat foods that are easy to eat, such as finger foods.”

d. “Invite family members to eat meals with you.”

e. “Exercise everyday to increase appetite.”

c. “Eat foods that are easy to eat, such as finger foods.”

d. “Invite family members to eat meals with you.”

e. “Exercise everyday to increase appetite.”

21
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A nurse is talking with an older adult client about improving nutritional status. Which of the following interventions should the nurse recommend?

a. Increase protein intake to increase muscle mass.

b. Decrease fluid intake to prevent urinary incontinence.

c. Increase calcium intake to prevent osteoporosis.

d. Limit sodium intake to prevent edema

e. Increase fiber intake to prevent constipation.

a. Increase protein intake to increase muscle mass.

c. Increase calcium intake to prevent osteoporosis.

d. Limit sodium intake to prevent edema

e. Increase fiber intake to prevent constipation.

22
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A nurse is teaching a group of client how to care for their colostomies. Which of the following statements indicates an issue with self concept?

a. “I was having difficulty with attaching the appliance at first, but my partner was able to help.”

b. “I’ll never be able to care for this at home. Can’t you just send a nurse to the house?”

c. “I met a neighbor who also has a colostomy, and they taught me a few things.”

d. “It can take me a while to get the hang of this. I have to admit, I am pretty nervous.”

b. “I’ll never be able to care for this at home. Can’t you just send a nurse to the house?”

23
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A nurse is caring for a group of clients on a medical-surgical unit. Which of the following clients are at increased risk for body-image disturbances?

a. A client who had a laparoscopic appendectomy

b. A client who had a mastectomy

c. A client who had a left above the knee amputation

d. A client who had a cardiac catheterization

e. A client who had a stroke who right sided hemiplegia

b. A client who had a mastectomy

c. A client who had a left above the knee amputation

e. A client who had a stroke who right sided hemiplegia

24
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A nurse is caring for a client who is 3 days postoperative following a below the knee amputation as a result of a motor vehicle crash. Which of the following statements indicates that the client has a distorted body image?

a. “I’ll be able to function exactly as I did before the accident.”

b. “I just can’t stop crying.”

c. “I am so mad at that guy who hit us. I wish he lost a leg

d. “I don’t even want to look at my leg. You can check the dressing.”

d. “I don’t even want to look at my leg. You can check the dressing.”

25
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A nurse is caring for a client who is recovering from a myocardial infarction as a cardiac cauterization. The client states, “I am concerned that things might be a little, you know, ‘different’ with my partner when I get home.” Which of the following statements should the nurse make?

a. “It sounds like something you should discuss with them when you get home.”

b. “It sounds like you are concerns about sexual functioning. Let’s discuss your concerns.”

c. Oh, I wouldn’t be too concerned. Things will be fine as soon as we get home.”

d. “Just make sure you take your medication as directed and you should be fine.”

b. “It sounds like you are concerns about sexual functioning. Let’s discuss your concerns.”

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A nurse is caring for a client who has left-sided hemiplegia resulting from a cerebrovascular accident. The client works as a carpenter and is now experiencing a situational role change based on physical limitations. The client is the primary wage earner in the family. Which of the following describes the client’s role problem?

a. role conflict

b. role overload

c. role ambiguity

d. role strain

a. role conflict

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A nurse is providing teaching with a newly licensed nurse about incorporating culturally responsive nursing care. Which of the following statements by the newly licensed nurse indicates understanding?

a. “It is a form of client ethnocentrism.”

b. “It involves being knowledgeable about various cultures.”

c. “It involves the delivery of care that includes the client’s beliefs.”

d. “It is the examination of the nurse’s personal attitude.”

c. “It involves the delivery of care that includes the client’s belief.”

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A nurse is using an interpreter to communicate with a client. Which of the following actions should the nurse take?

a. using a facility approved medical interpreter

b. determining the client’s understanding several times during the conversation

c. looking at the interpreter when asking the client questions

d. using medical terms during the conversation

e. asking 1 question at a time

a. using a facility approved medical interpreter

b. determining the client’s understanding several times during the conversation

e. asking 1 question at a time

29
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A nurse is using the FICA screening tool to gather more data about a client’s interfaith needs. Which of the following questions should the nurse ask when using the tool?

a. “What gives you a sense of purpose?”

b. “Who inspires you?”

c. “How has this condition affected you?”

d. “Do you have a communication barrier?”

a. “What gives you a sense of purpose?”

30
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A nurse working in an ambulatory care center provides care for patients experiencing varying levels of health and illness. The nurse bases care on which concepts of health and illness? Select all that apply

a. Health and illness are the same for all people.

b. Health and illness are individually defined by each person.

c. People with acute illnesses may consider themselves healthy.

d. People with chronic illnesses have poor health beliefs.

e. Health is more than the absence of illness.

f. Illness is the response of a person to a disease.

b. Health and illness are individually defined by each person.

c. People with acute illnesses may consider themselves healthy.

e. Health is more than the absence of illness.

f. Illness is the response of a person to a disease.

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A community health nurse is developing a support group for patients coping with chronic health problems. What chronic health conditions does the nurse anticipate group members might want to discuss? Select all that apply.

a. Diabetes mellitus

b. Bronchial pneumonia

c. Rheumatoid arthritis

d. Ulcerative colitis

e. Fractured hip

f. Otitis media

a. Diabetes mellitus

c. Rheumatoid arthritis

d. Ulcerative colitis

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Nurses from hospital in a low-income area of the city are developing educational materials and programs focused on health care for vulnerable populations. When planning community outreach, which members of the community will the nurses include? Select all that apply.

a. White male diagnosed with HIV

b. Black teenager who is 6 months pregnant

c. Hispanic male who has type 2 diabetes

d. Low-income family living in rural America

e. Middle-class teacher living in a large city

f. White infant born with cerebral palsy

b. Black teenager who is 6 months pregnant

c. Hispanic male who has type 2 diabetes

d. Low-income family living in rural America

f. White infant born with cerebral palsy

33
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A nurse has volunteered to give influenza immunizations at a local health clinic. In which level of health promotion and illness prevention is the nurse participating?

a. Tertiary

b. Secondary

c. Primary

d. Promotive

c. Primary

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A community health nurse cares for vulnerable populations. What problem will the nurse prioritize for a patient who is homeless?

a. Love and belonging

b. Safety

c. Self-esteem

d. Self-actualization

b. Safety

35
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A clinic nurse works with a population experiencing health disparities. Which patient does the nurse identify as having the highest risk for postponing annual breast examinations and mammograms?

a. Patient whose best friend had a benign breast lump removed

b. Patient who lives in a low-income neighborhood

c. Patient who has a family history of breast cancer

d. Patient whose family encourages regular physical examinations

b. Patient who lives in a low-income neighborhood

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A nursing student is writing a paper about nurses performing health promotion activities at the tertiary level. Which nursing actions will the student include? Select all that apply.

a. Running an immunization clinic in a lower-income area of a city

b. Teaching a patient with an amputation how to care for the residual limb

c. Providing range-of-motion exercises for a patient who is paralyzed

d. Teaching parents of toddlers how to childproof their homes

e. Providing screening for scoliosis for school students

f. Teaching new parents how to choose and use an infant car seat

b. Teaching a patient with an amputation how to care for the residual limb

c. Providing range-of-motion exercises for a patient who is paralyzed

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A nurse is caring for a patient who has been managing their chronic spasticity well for 10 years. The patient states having had increasing spasticity and few falls due to unremitting muscle spasms. The nurse, patient, and health care provider discuss the possibility the patient may be experiencing which phase of illness?

a. Acute onset of illness

b. Permanent complication

c. Need for hospice care

d. Exacerbation of disease

d. Exacerbation of disease

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A nurse incorporates concepts from current models of health when providing health promotion classes for patients. What is a key concept of both the health–illness continuum and the high-level wellness models?

a. Illness as a fixed point in time

b. The importance of family

c. Wellness as a passive state

d. Health as a dynamic state

d. Health as a dynamic state

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A public health nurse is planning interventions for a community and plans to determine the frequency of diseases in the area. What information will best guide the nurse?

a. Morbidity table

b. Disease eradication statistics

c. Mortality rates

d. Annual hospital admissions

a. Morbidity table

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A nurse is caring for patients of diverse cultures in a community health clinic. Which concepts will the nurse incorporate to guide the plan of care? Select all that apply.

a. The United States has become less inclusive of same-sex couples.

b. Cultural diversity is limited to people of varying cultures and races.

c. Cultural diversity is separate and distinct from health and illness.

d. People may be members of multiple cultural groups at one time.

e. Culture guides what is acceptable behavior for people in a specific group.

f. Cultural practices may evolve over time but mainly remain constant

d. People may be members of multiple cultural groups at one time.

e. Culture guides what is acceptable behavior for people in a specific group.

f. Cultural practices may evolve over time but mainly remain constant

41
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At the last staff meeting, the nurse manager discussed the organizational initiative to improve provision of culturally competent care. During rounds, which behaviors inconsistent with this goal require the manager to intervene? Select all that apply.

a. A staff nurse tells the AP that patients should not be given a choice, but should shower or bathe daily.

b. A nurse asks the family of a patient who has died if they would like to wash their loved one’s body.

c. A nurse tells another nurse that Jewish dietary restrictions are just a way for them to get special foods.

d. A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence.

e. A nurse obtains a translator to speak to the patient in their native language.

f. A nurse refuses to care for a married gay patient who is HIV positive because the nurse is against same-sex marriage.

a. A staff nurse tells the AP that patients should not be given a choice, but should shower or bathe daily.

d. A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence.

42
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An ambulatory care nurse serving a large, culturally diverse population is planning a free blood pressure screening clinic. Based on the nurse’s understanding of racial differences in health and illness, which groups will the nurse target for screening? Select all that apply.

a. Native American people

b. African American people

c. Alaska Native people

d. Asian people

e. White people

f. Hispanic people

b. African American people

d. Asian people

e. White people

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A nurse is using the Explanatory Model of Health and Illness (ESFT) model to assess how a patient from another culture views their diagnosis of chronic obstructive pulmonary disease (COPD). What interview question is most appropriate to assess the E aspect of this model?

a. How do you get your medications?

b. How does having COPD affect your lifestyle?

c. Are you concerned about the side effects of your medications?

d. Can you describe how you will take your medications?

b. How does having COPD affect your lifestyle?

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A nurse tells a patient, “tonight’s menu selection is pork. I understand many people in your culture do not eat pork; may I order something else for you?” When the patient states they no longer observe this dietary practice, the nurse understands that the patient has experienced what transition?

a. Cultural assimilation

b. Cultural imposition

c. Culture shock

d. Ethnocentrism

a. Cultural assimilation

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The charge nurse overhears a nurse state, “That patient is 78 years old—too old to learn how to change a dressing.” How should the charge nurse respond?

a. “Please don’t impose your view of the patient’s culture on them.”

b. “I wish you would try to demonstrate more cultural sensitivity.”

c. “Try to be open to your patient’s culture, to make the biggest impact.”

d. “Grouping all older adults as having trouble learning is a form of stereotyping.”

d. “Grouping all older adults as having trouble learning is a form of stereotyping.”

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A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish, and the nurse speaks only English. Which action should the nurse take next?

a. Use short words and speak loudly

b. Obtain a medical interpreter

c. Explain why care cannot be provided

d. Provide instructions in writing

b. Obtain a medical interpreter

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A nurse is interviewing a newly admitted patient from another culture. What question best displays cultural sensitivity?

a. “Do you think you’ll be able to eat the food we have here?”

b. “You do understand that we can’t prepare special meals?”

c. “What types of food do you typically prepare for meals?”

d. “Could you make an exception on what food you eat while you are here?”

c. “What types of food do you typically prepare for meals?

48
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A nurse tells a new mother from Africa that she should not carry her infant in a sling because bassinets are safer. The charge nurse suggests the nurse is displaying which behavior?

a. Cultural imposition

b. Clustering

c. Cultural competency

d. Stereotyping

a. Cultural imposition

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A community organization includes provision of culturally competent care in their mission. Which action has the organization set as a priority?

a. Learning the predominant language of the community

b. Obtaining significant information about the community

c. Treating each patient at the clinic as an individual

d. Recognizing the importance of the patient’s family

c. Treating each patient at the clinic as an individual

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A surgeon will not attempt a life-saving repair of a ruptured aneurysm unless the patient agrees to receive blood transfusions. Although receiving blood products is against the patient’s religious beliefs, the surgeon ordered four units of packed red blood cells. Which action will the nurse take first?

a. Administer the blood transfusion

b. Call the patient’s family and ask them to reason with the patient

c. Discuss obtaining a court order to save the patient’s life

d. Maintain the patient’s comfort and support their decision

d. Maintain the patient’s comfort and support their decision

51
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A nurse caring for older adults in a provider’s office researches aging theories to help determine why some people age more rapidly than others. Which statements describe the immunity theory of the aging process? Select all that apply.

a. Immunosenescence likely promotes the increase in infections in the older adult.

b. Free radicals have adverse effects on adjacent molecules.

c. Decreases in size and function of the thymus result in more infections.

d. Nutrition likely plays an important role in maintaining the immune response.

e. Lifespan depends to a great extent on genetic factors.

f. Organisms wear out from increased metabolic functioning.

d. Nutrition likely plays an important role in maintaining the immune response.

e. Lifespan depends to a great extent on genetic factors.

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A nursing student caring for older adults in a skilled nursing facility is completing an assignment identifying physical changes that are part of normal aging. What changes will the student include in this assignment? Select all that apply.

a. Fatty tissue is redistributed.

b. Skin is drier and wrinkles appear.

c. Cardiac output increases.

d. Muscle mass increases.

e. Hormone production increases.

f. Visual and hearing acuity diminishes.

b. Skin is drier and wrinkles appear.

d. Muscle mass increases.

f. Visual and hearing acuity diminishes.

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A nurse researcher interviews adults to validate Erikson’s theory that middle-aged adults who do not achieve their developmental tasks may be in the stage of stagnation. Which patient statement will the nurse correlate to this theory?

a. “I am helping my parents move into an assisted-living facility.”

b. “I spend all of my time going to the doctor to be sure I am not sick.”

c. “I have enough money to help my son and his wife when they need it.”

d. “I earned this gray hair and I like it!”

b. “I spend all of my time going to the doctor to be sure I am not sick.”

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A nurse providing health services for a community setting for people age 55 years and older considers health problems for these residents. Which of the following problems is most appropriate for many middle-aged adults?

a. Adequate nutrition

b. Mental health problems

c. Abuse

d. Caregiver role strain

d. Caregiver role strain

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The charge nurse in a long-term care facility discusses ageism with new nurse employees. Nurses are asked to intervene if they observe which of these examples demonstrating ageism?

a. The AP encourages older adults to apply makeup or aftershave to promote positive self-image.

b. The activity director explains to an older adult they could learn to use video conferencing to speak to their grandchildren.

c. A nurse colleague states that older adult should not think about having a boyfriend or girlfriend after age 70 years.

d. A nurse recognizes the patient who lost their partner of 45 years may be experiencing loneliness.

c. A nurse colleague states that older adult should not think about having a boyfriend or girlfriend after age 70 years.

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A nurse is caring for older adults in a senior adult day services (ADS) center. Which findings require follow up with the health care provider?

a. Skin pigmentation caused by exposure to sun over the years

b. Thin toenails with a bluish tint to the nail beds

c. Using a walker while healing from a hip fracture related to brittle bones

d. Bruising on forearms due to fragile blood vessels in the dermis

b. Thin toenails with a bluish tint to the nail beds

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A nursing instructor teaching a gerontology class to nursing students discusses myths related to the aging of adults. Which statement will the students identify as a myth about older adults?

a. Most older adults live in their own homes.

b. Healthy older adults enjoy sexual activity.

c. Aging results in mental deterioration.

d. Older adults want to be attractive to others.

c. Aging results in mental deterioration.

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A nurse is helping to prepare a calendar for an older adult patient with cognitive impairment. Which type of cognitive impairment is non-reversible?

a. Post-stroke speech issues

b. Malnutrition

c. Alzheimer’s disease

d. Loss of cardiac reserve

c. Alzheimer’s disease

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A nurse caring for an older adult living in a long-term care facility uses reminiscence to help the patient adapt to the changes of aging. The nurse uses which question to encourage reminiscence?

a. “Tell me about how you celebrated Christmas when you were young.”

b. “Tell me how you plan to spend your time this weekend.”

c. “Did you enjoy the choral group that performed here yesterday?

d. “Why don’t you want to talk about your feelings?”

a. “Tell me about how you celebrated Christmas when you were young.”

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Following a fall that left an older adult temporarily bedridden, the nurse is using the SPICES assessment tool to evaluate for cascade iatrogenesis. Which are correct aspects of this tool? Select all that apply.

a. S—Senility

b. P—Problems with feeding

c. I—Irritability

d. C—Confusion

e. E—Edema of the legs

f. S—Skin breakdown

b. P—Problems with feeding

d. C—Confusion

f. S—Skin breakdown

S—Sleep disorders

P—Problems with eating or feeding

I—Incontinence

C—Confusion

E—Evidence of falls

S—Skin breakdown

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The nurse in a long-term care facility states in report that an older adult resident is quite frail. The oncoming caregiver prioritizes prevention of what problem?

a. Confusion

b. Falls

c. Delirium

d. Dementia

b. Falls

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A patient is admitted to the acute care medical center with change in mental status, dehydration, and electrolyte imbalances. Which of these reflects a reversible cause of the changes in mental status?

a. Alzheimer’s disease

b. Delirium

c. Dementia

d. Delirium superimposed on dementia

b. Delirium

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A nurse is teaching a client about performing a fecal occult blood test at home. Which of the following information should the nurse include?

a. Do not eat red meat within one day of the test

b. One stool specimen is sufficient for testing

c. A red color change indicates a positive test

d. Ensure the specimen does not include urine

d. Ensure the specimen does not include urine

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A nurse is preparing to administer a cleansing enema to a client. Place the steps the nurse should plan to take in the correct order.

Slowly insert the rectal tube into the client’s rectum

Warm the enema solution

Ask the client to retain the solution

Lubricate the end of the rectal tube

Hang the enema container 30-45cm (12-18in) above the client’s anus

  1. Warm the enema solution

  2. Lubricate the end of the rectal tube

  3. Slowly insert the rectal tube into the client’s rectum

  4. Hand the enema container 30-45cm (12-18in) above the client’s anus

  5. Ask the client to retain the solution

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A nurse is administering a cleansing enema to a client who report abdominal cramping. What actions should the nurse take?

When taking action, the nurse should slow the flow of the solution by lowering the container. Slowing the slow of the enema should decrease abdominal cramping. If the client is experiencing severe abdominal cramping, stop the enema, assess the client’s vital signs, and notify the provider.

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A nurse is teaching a client who has recurrent UTIs. Which of the following instructions should the nurse include? Select all that apply.

a. Urinate after sexual intercourse

b. Drink at least 1L of fluid each day

c. Clean perineum from the front to back

d. Wear nylon undergarments

e. Avoid bubble baths

a. Urinate after sexual intercourse

c. Clean perineum from the front to back

e. Avoid bubble baths

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A nurse is teaching a newly licensed nurse about urine specimen collection. Match the following tests to the procedure.

Random urinalysis

Clean-catch midstream for culture and sensitivity (C&S)

Timed urine specimen

Catheter urine specimen for C&S

_____________________________________

Collect urine for 24hr period

Obtain a non-sterile urine specimen

Obtain a sterile urine specimen from an indwelling urinary catheter

Clean the urethral meatus prior to obtaining the urine specimen

Collect urine for a 24h period - Timed urine specimen

Obtain a nonsterile urine specimen - random urinalysis

Obtain a sterile urine specimen from an indwelling urinary catheter - catheter urine specimen for C&S

Clean the urethral meatus prior to obtaining the urine specimen- clean catch midstream for culture and sensitivity (C&S)

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A nurse is caring for a client who has an indwelling urinary catheter. Which of the following actions should the nurse take? Select all that apply.

a. Empty the client’s urinary drainage bag when it is ¾ full

b. Keep the urinary bag below the level of the client’s bladder

c. Assess the client’s need for the indwelling urinary catheter daily

d. Rest the urinary collection bag on the floor when the client is sitting in a chair

e. Maintain a closed system of the client’s urinary catheter

b. Keep the urinary bag below the level of the client’s bladder

c. Assess the client’s need for the indwelling urinary catheter daily

e. Maintain a closed system of the client’s urinary catheter

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A nurse is teaching a client who reports stress urinary incontinence. What instructions should the nurse include?

Maintain adequate fluid intake, empty bladder completely with each void, avoid bladder irritants, such as caffeine and alcohol and perform pelvic muscle exercises (Kegel) 3-4 times each day.

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A nurse is preparing to initiate a bladder-retaining program for a client who has urge incontinence. Which of the following action should the nurse take?

a. Restrict the client’s intake of fluids during the daytime

b. Have the client record urination times.

c. Gradually increase the time of the client’s urination intervals

d. Remind the client to try to control urine until the next scheduled urination time.

e. restrict the client’s coffee intake to 2 servings each day

b. Have the client record urination times.

c. Gradually increase the time of the client’s urination intervals

d. Remind the client to try to control urine until the next scheduled urination time.

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Nursing students are reviewing information about health care delivery systems in post conference. Which statements describing current U.S. health care delivery practices should be included in the discussion? Select all that apply.

a. Access to care depends only on the ability to pay, not the availability of services.

b. The Patient Protection and Affordable Care Act provides private health care insurance to underserved populations.

c. Every health insurance plan in the Health Insurance Marketplace offers comprehensive coverage, from doctors to medications to hospital visits.

d. The uninsured pay for more than one third of their care out of pocket and are usually charged lower amounts for their care than the insured pay.

e. Fifty years ago, half of the doctors in the United States practiced primary care, but today fewer than one in three do.

f. Quality of care can be defined as the right care for the right person at the right time.

c. Every health insurance plan in the Health Insurance Marketplace offers comprehensive coverage, from doctors to medications to hospital visits.

e. Fifty years ago, half of the doctors in the United States practiced primary care, but today fewer than one in three do.

f. Quality of care can be defined as the right care for the right person at the right time.

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Nurses provide care to patients in secondary health care facilities. Which patients do the nurses anticipate will receive this type of care? Select all that apply.

a. Patient seeking treatment at a community clinic for possible strep throat

b. Patient treated in the hospital following a myocardial infarction

c. Child brought to the emergency department following a seizure

d. Individual with osteogenesis imperfecta being treated in a medical center

e. Child visiting a specialist to correct a congenital heart defect

f. Patient who has a hernia repair in an ambulatory care center

b. Patient treated in the hospital following a myocardial infarction

c. Child brought to the emergency department following a seizure

f. Patient who has a hernia repair in an ambulatory care center

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A nurse working in a primary care facility prepares insurance forms in which the provider is given a fixed monetary amount per enrollee in the health plan. What term do the nurses apply to this type of reimbursement?

a. Capitation

b. Prospective payment system

c. Bundled payment

d. Rate setting

a. Capitation

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A nurse working in a pediatric clinic provides codes for a patient’ s services to a third-party payer who pays all or most of the care. How does the nurse refer to this method of payment?

a. Out-of-pocket payment

b. Individual private insurance

c. Employer-based group private insurance

d. Government financing

b. Individual private insurance

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A nurse researcher follows current trends in health care delivery. Which present-day trends does the nurse observe? Select all that apply.

a. Globalization of the economy and society

b. Slowdown in technology development

c. Decreasing diversity

d. Increasing complexity of patient care

e. Changing demographics

f. Shortages of key health care professionals and educators

a. Globalization of the economy and society

d. Increasing complexity of patient care

e. Changing demographics

f. Shortages of key health care professionals and educators

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A nursing student is assisting with nursing care for patients in a primary care center. Based on the setting, what activities will the student expect to perform?

a. Assisting with major surgery

b. Performing health assessments

c. Maintaining patients’ function and independence

d. Maintaining immunization records

b. Performing health assessments

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The caregiver for a patient who is immobile and requires tube feedings asks the nurse to explain respite care. How does the nurse best explain this type of care?

a. “It’s a type of service that allows time away for caregivers.”

b. “It provides comfort and end-of-life services for the terminally ill and their families.”

c. “It is skilled care provided to older adults in a long-term care facility.”

d. “It provides living units available to people without regular shelter.”

a. “It’s a type of service that allows time away for caregivers.”

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A nurse caring for patients in a primary care setting submits paperwork for reimbursement from managed care plans for services provided. What best describes managed care?

a. System designed to control cost of care while maintaining quality

b. Care coordination to maximize positive outcomes to contain costs

c. Delivery of services from initial contact through ongoing care

d. Based on a philosophy of ensuring death in comfort and dignity

a. System designed to control cost of care while maintaining quality

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As part of a clinical paper, a nursing student interviews a hospice nurse about their role. How will the student describe the type of care the nurse provides?

a. Physical, psychological, social, and spiritual care for dying patients, their families, and loved ones

b. Preventive, primary care, focusing on diabetes education, immunizations, and prenatal care

c. Care focusing on rare diseases and specialty care

d. Care to meet the patient’s health care needs while giving a break to the patient’s caregiver

a. Physical, psychological, social, and spiritual care for dying patients, their families, and loved ones

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Nursing students learn advance practice nurses can write medication prescriptions. Which roles may be performed by an advanced practice registered nurse? Select all that apply.

a. Primary care provider

b. Hospitalist

c. Physical therapist

d. Anesthetist

e. Midwife

f. Pharmacist

a. Primary care provider

d. Anesthetist

e. Midwife

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The nurses at a large community hospital with several campuses are members of a committee working toward obtaining Magnet status. What activity will best meet their goal?

a. Recruiting excellent surgeons and medical doctors

b. Offering health prevention activities in the community

c. Providing high-quality patient care, using innovative practices

d. Seeking culturally diverse clergy to meet patient’s spiritual concerns

c. Providing high-quality patient care, using innovative practices

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During a meeting with nurses at all levels in an acute care hospital, the Director of Nursing discusses lost revenue due to Medicare penalties. The nurses plan improvements in practice designed to prevent penalties from which events? Select all that apply.

a. Urinary catheter–related infections

b. Blood infections from central venous catheters

c. Excessive readmissions

d. Pressure injuries

e. High blood pressure

a. Urinary catheter–related infections

b. Blood infections from central venous catheters

c. Excessive readmissions

d. Pressure injuries

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Nursing students are asked to provide interprofessional care during their clinical experience. Which member of the health care team will the student contact for an uninsured patient?

a. Nurse practitioner

b. Admissions coordinator

c. Social worker

d. Hospital chaplain

c. Social worker

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A school nurse determines that a student who has lost weight is at risk for an eating disorder and would benefit from a nutritional assessment. What action will the nurse take?

a. Perform a focused nutritional assessment

b. Seek direction from the student’ s health care provider

c. Suggest the student visit the nurse-run clinic

d. Request a consultation with a nutritionist

a. Perform a focused nutritional assessment

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A nurse is caring for a group of patients. Which actions are appropriate to include in the implementation phase of care? Select all that apply.

a. Changing the dressings on a burn victim’ s arm

b. Assessing a patient’ s nutritional intake

c. Formulating a nursing diagnosis for a patient with epilepsy

d. Turning a patient in bed every 2 hours to prevent pressure injuries

e. Checking a patient’ s insurance coverage at the initial interview

f. Determining availability of community resources for a patient with dementia

a. Changing the dressings on a burn victim’ s arm

d. Turning a patient in bed every 2 hours to prevent pressure injuries

f. Determining availability of community resources for a patient with dementia

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Nurses use the Nursing Interventions Classification (NIC) Taxonomy structure as a resource to plan nursing care for patients. What information is found in this structure?

a. Case studies illustrating a complete set of activities that a nurse performs to carry out nursing interventions

b. Nursing interventions, each with a label, a definition, and a set of activities that a nurse performs to carry it out, with a short list of background readings

c. Complete list of nursing diagnoses, outcomes, and related nursing activities for each nursing intervention

d. Complete list of reimbursable charges for each nursing intervention

b. Nursing interventions, each with a label, a definition, and a set of activities that a nurse performs to carry it out, with a short list of background readings

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A nurse works in a long-term care facility where standing orders are in place for influenza vaccines for all residents. What is the nurse’ s priority, when carrying out the prescriptions?

a. Assessing whether the patient previously received the vaccine

b. Refusing to give the vaccine without a written prescription

c. Determining if the standing orders are inappropriate for their unit

d. Calling the nursing supervisor to determine if this is a permitted action

a. Assessing whether the patient previously received the vaccine

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A nurse performs nurse-initiated nursing actions when caring for patients in a skilled nursing facility. Which reflect these types of actions? Select all that apply.

a. Administering an antibiotic to a patient with pneumonia

b. Consulting with a psychiatrist for a patient who misuses opiates

c. Checking the skin of bedridden patients for skin breakdown

d. Ordering a kosher meal for an orthodox Jewish patient

e. Recording a patient’ s intake and output

f. Preparing a patient for surgery according to facility protocol

c. Checking the skin of bedridden patients for skin breakdown

d. Ordering a kosher meal for an orthodox Jewish patient

f. Preparing a patient for surgery according to facility protocol

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A nurse enters the patient’ s room to perform pin-site care for a patient wearing a halo vest to stabilize the cervical spine. What action will the nurse take first?

a. Administer pain medication

b. Reassess the patient

c. Prepare the equipment

d. Explain the procedure to the patient

b. Reassess the patient

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The charge nurse tells a nursing student to change a surgical dressing while they take care of other patients. The student has not changed dressings before and does not feel confident performing the procedure. What action should the student take?

a. Tell the charge nurse that they lack the technical competencies to change the dressing independently

b. Assemble the equipment for the procedure and follow the steps in the procedure manual

c. A sk another student nurse to work collaboratively with them to change the dressing

d. Tell the clinical instructor they have not had experience with the delegated task

a. Tell the charge nurse that they lack the technical competencies to change the dressing independently

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A nurse develops a care plan for an adolescent patient who gave birth to a premature infant. When presented with the collaborative care plan, including home health care visits, the patient states, “We will be fine on our own. I don’ t need any more care.” What is the nurse’ s best response?

a. “You know your personal situation better than I do; I will respect your wishes.”

b. “If you don’t accept these services, your baby’s health will suffer.”

c. “Let’s take a look at the plan again and see if we can adjust it to fit your needs.”

d. “I’m going to assign your case to a social worker who can explain the services better.”

c. “Let’s take a look at the plan again and see if we can adjust it to fit your needs.”

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An RN working on a hospital unit frequently delegates patient care to assistive personnel (AP). Which activities are appropriate for the nurse to safely delegate? Select all that apply.

a. Performing patient assessments

b. Making patient beds

c. Giving patients bed baths

d. Administering oral medications

e. Ambulating patients

f. Assisting patients with meals

b. Making patient beds

c. Giving patients bed baths

e. Ambulating patients

f. Assisting patients with meals

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A nursing student is prioritizing interventions for a patient with diabetes who needs diagnostic testing, dressing changes, meal planning and counseling, and assistance with hygiene. The patient states, “I must have my hair washed before I can do anything else; I’m ashamed of the way I look.” How will the student best prioritize this patient’s care?

a. Explain to the patient that there is not enough time to wash their hair today because of the busy schedule

b. Schedule the testing and meal planning first and complete hygiene as time permits

c. Perform the dressing changes first, schedule the testing and counseling, and complete hygiene last

d. Wash the patient’s hair and perform hygiene, schedule testing and counseling, then change the dressing

d. Wash the patient’s hair and perform hygiene, schedule testing and counseling, then change the dressing

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A nurse is caring for a patient with a painful, non-healing surgical wound. The patient does not request pain medication because they do not want to be a burden. What actions will the nurse implement to improve pain relief? Select all that apply.

a. Reestablishing the pain level the patient finds acceptable as the pain management goal

b. Obtaining a dry-erase board to remind the patient of the plan of care

c. Assessing the patient’s pain and offering analgesia during hourly rounding

d. Placing the analgesic underneath other medications and quickly handing it to the patient

e. Asking the family members to speak to the patient about pain relief

a. Reestablishing the pain level the patient finds acceptable as the pain management goal

b. Obtaining a dry-erase board to remind the patient of the plan of care

c. Assessing the patient’s pain and offering analgesia during hourly rounding

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A nursing unit has adopted use of a care bundle for insertion of central venous catheters. During the procedure, which action by a nurse requires the charge nurse to intervene?

a. They discard the sterile drapes in the insertion kit.

b. The primary nurse reminds everyone in the room to wear a mask.

c. The team includes every item in the bundle during the procedure.

d. The nursing student states using the bundle improves patient outcomes.

a. They discard the sterile drapes in the insertion kit.

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A university student works with the student health nurse to develop a weight loss plan that includes increasing activity and avoiding empty calories. At the next session, the student has lost 1 lb instead of the projected 5 lb. What action will the nurse take next?

a. Congratulate the student and continue the care plan

b. Terminate the care plan since it is not working

c. Give the student more time to reach the targeted outcome

d. Modify the plan after discussing possible reasons for partial success

d. Modify the plan after discussing possible reasons for partial success

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A visiting nurse is following up with a patient who was given a prescription for a diuretic and told to chart her weight daily. The patient’s weight has increased 5 lb since the nurse’s last visit. What actions will the nurse take first?

a. Explain to the patient that it is clear she is not adhering to her prescription and the health care provider will be notified

b. Document the 5-lb weight gain and ask the patient about sodium intake and medication side effects

c. Terminate the plan of care while determining the cause for the weight gain

d. Encourage the patient to continue the prescription and return in 1 week

b. Document the 5-lb weight gain and ask the patient about sodium intake and medication side effects

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During orientation to the critical care unit, a nurse learns that staff follow existing clinical practice guidelines, also called standards, for patient care. Which activities does the nurse expect to be included in these guidelines? Select all that apply.

a. Monitoring vital signs and pulse oximetry every hour

b. Using intuition to troubleshoot patient problems

c. Repositioning a patient on bed rest every 2 hours

d. Becoming a nurse mentor to a student nurse

e. Administering pain medication prescribed by the health care provider

f. Becoming involved in community nursing events

a. Monitoring vital signs and pulse oximetry every hour

c. Repositioning a patient on bed rest every 2 hours

e. Administering pain medication prescribed by the health care provider

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After reviewing the admission SBAR and plan of care, the nurse begins to evaluate patient outcomes. Which statement reflects a clear evaluation of the patient’s primary problem?

Electronic health record (EHR)

8:00 AM Admission note

S. Patient with profound wheezing, tachycardia, and anxiety

B. Patient has history of asthma, for which she regularly uses inhalers and carries a rescue inhaler

A. Pulse oximetry 89%, cyanosis of lips, dyspnea with increased work of breathing

R. Admit to telemetry unit, add IV corticosteroids and mini-nebulizer treatments

a. The patient states they were terrified when they were fighting to breathe and the wheezing would not stop.

b. The nurse determines the patient’s strengths include adherence to their medication regimen.

c. The care plan includes the health problem of impaired gas exchange, etiology, bronchospasm.

d. At 10:00 AM, no wheezing on auscultation, pulse oximetry is 94%, the patient reports no anxiety; the outcome has been met.

d. At 10:00 AM, no wheezing on auscultation, pulse oximetry is 94%, the patient reports no anxiety; the outcome has been met.

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A nurse is writing nursing outcomes in the affective domain for a patient who is trying to stop smoking. Which outcome statement will the nurse include in the care plan?

a. “The patient will state the relationship between smoking and coronary artery disease.”

b. “After the teaching session, the patient will redemonstrate the proper application of a nicotine patch.”

c. “The patient will state they value a healthy body sufficiently to stop smoking prior to discharge.”

d. “The patient will state that any changes in cough should be reported to the health care provider”

c. “The patient will state they value a healthy body sufficiently to stop smoking prior to discharge.”