fundamental practice (1.1)

1. A nurse walks into a break room and overhears another nurse discussing a patient’s HIV status. Which of the following actions is most appropriate for the nurse to take?

A. Notify the charge nurse
B. Ignore the conversation
C. Join the discussion and offer input
D. Ask the nurse to stop, but take no further action

A

2. A patient is scheduled for a thoracentesis. When the nurse brings the consent form to the bedside, the patient says, “What’s that procedure again?” What is the nurse’s best response?

A. “It’s just a minor drainage procedure.”
B. “Don’t worry. The doctor knows what they’re doing.”
C. “I’ll have the provider return and explain it again.”
D. “You already signed the consent earlier.”

C

3. The nurse is caring for a patient with an advance directive indicating “DNR” status. The patient suddenly becomes unresponsive and pulseless. Which action by the nurse is correct?

A. Begin CPR immediately
B. Verify the DNR order before taking action
C. Call the healthcare provider for clarification
D. Alert the rapid response team and begin compressions

B

4. Which task is most appropriate for the RN to delegate to a UAP?

A. Apply a warm compress to an abdominal wound
B. Assess for bleeding under a surgical dressing
C. Perform passive range of motion on an immobile patient
D. Teach a patient how to use an incentive spirometer

C

5. A nurse is planning assignments for the day. Which client is best suited for the LPN?

A. A new post-op patient requiring frequent assessments
B. A client with unstable blood glucose needing insulin titration
C. A client with pneumonia needing oral antibiotics and suctioning
D. A trauma patient being prepped for emergency surgery

C

6. Which of the following are violations of HIPAA? (Select all that apply)

A. Texting a provider patient details using a secure hospital app
B. Leaving a chart open in a public hallway
C. Sharing patient photos in a private nurse group
D. Calling out patient names in the waiting room
E. Discussing patient care in an elevator

BCE Leaving a chart open in a public hallway, sharing patient photos in a private nurse group, and discussing patient care in an elevator are all violations of HIPAA regulations.

7. A patient signed a consent form for surgery after receiving morphine 30 minutes earlier. Which statement is true?

A. The consent is valid if the patient was alert
B. The consent is invalid due to the sedative
C. The nurse can validate the consent with a signature
D. The provider can override the consent if urgent

B

8. The RN receives report on 4 clients. Which patient should the nurse see first?

A. A client with a DNR who is requesting spiritual counseling
B. A post-op client with a respiratory rate of 10 breaths/min
C. A diabetic patient with a blood glucose of 140
D. A client who needs assistance with bathing

B

9. Which of the following tasks can an LPN perform? (Select all that apply)

A. Monitor a patient with a stable tracheostomy
B. Perform the initial admission assessment
C. Administer a subcutaneous heparin injection
D. Educate a client on managing heart failure
E. Suction a trach with stable vitals

A C E

10. What is the most appropriate action if a UAP reports that a patient “looks pale and is acting weird”?

A. Ask the UAP to recheck the patient’s vitals
B. Go assess the patient yourself immediately
C. Delegate the assessment to another UAP
D. Document the UAP’s observation in the chart

B

11. The nurse is providing care to a competent adult who refuses a blood transfusion due to religious beliefs. What is the nurse’s priority action?

A. Inform the physician
B. Attempt to educate the patient further
C. Respect the patient’s refusal
D. Document and proceed with the transfusion

c

12. A patient’s wife asks the nurse for an update on her husband’s condition. The patient has not signed a release. What should the nurse do?

A. Provide basic information since she’s his wife
B. Ask her to sign a consent form
C. Ask the patient for verbal permission
D. Explain that you cannot release info without consent

D

13. A nurse is caring for a 17-year-old who is legally emancipated and needs surgery. Who must sign the consent form?

A. The patient’s parent
B. The legal guardian
C. The healthcare proxy
D. The patient

D

14. A nurse is assigned to care for a patient undergoing radiation. Which action would violate HIPAA?

A. Charting care at a nursing station
B. Writing the patient’s full name on the whiteboard
C. Using a room number for specimen labels
D. Updating the patient using initials on status board

b

15. Which statement by the nurse indicates a proper understanding of delegation?

A. “I can delegate sterile wound care to a UAP.”
B. “I’ll assign IV push medications to the LPN.”
C. “I’ll have the UAP ambulate the post-op patient with stable vitals.”
D. “I’ll ask the LPN to complete the initial admission assessment.”

C

1. A nurse is caring for a patient with a history of domestic violence. The partner demands to know the patient’s condition. What should the nurse do?

A. Call security to remove the partner
B. Provide minimal information to avoid escalation
C. Confirm the partner’s identity and provide an update
D. Refuse to give information without patient consent

d

2. A student nurse is shadowing and hears a nurse discussing a patient's diagnosis in the hospital cafeteria. What action should the student nurse take?

A. Walk away quietly
B. Join the conversation to learn more
C. Report the situation to the clinical instructor
D. Record the conversation for proof

c

3. The nurse assigns a new UAP to take vital signs on four patients. Which action by the nurse demonstrates appropriate delegation?

A. Tells the UAP to report only abnormal findings
B. Supervises the UAP performing the first round of vitals
C. Instructs the UAP to chart directly in the EMR
D. Asks the UAP to assess pain during vital checks

b

4. Which patient scenario requires the RN to intervene immediately?

A. An LPN administers oral antibiotics to a stable pneumonia patient
B. A UAP performs passive ROM on a stroke patient
C. A UAP applies an abdominal binder to a fresh post-op patient
D. An RN educates a diabetic patient on insulin injection

c

5. A 16-year-old emancipated minor is scheduled for surgery. The nurse should:

A. Request consent from the parent
B. Delay surgery until the provider signs consent
C. Obtain informed consent from the patient
D. Have both patient and parent sign consent

c

6. A nurse accesses the medical record of a patient not under her care out of curiosity. What legal concept has been violated?

A. Negligence
B. Malpractice
C. Breach of confidentiality
D. False imprisonment

c

7. Which of the following actions would violate the Security Rule under HIPAA? (Select all that apply)

A. Leaving a computer screen open and unattended
B. Faxing lab results using a cover sheet
C. Storing patient data on a personal flash drive
D. Logging off a shared computer before walking away
E. Texting patient info on an unencrypted device

ace

8. Which task is unsafe for a nurse to delegate to a UAP?

A. Turning a patient every 2 hours
B. Checking a patient’s blood glucose level
C. Ambulating a patient after surgery
D. Applying a prescribed transdermal patch

d

9. A nurse is reviewing a surgical consent form and notices the patient is hard of hearing and nodding but not asking questions. What should the nurse do?

A. Proceed with the signature
B. Have the patient repeat back the procedure
C. Notify the provider to re-explain the procedure
D. Use hand gestures to reinforce understanding

c

10. A nurse disagrees with a provider’s DNR order and continues CPR on a patient. What ethical principle has been violated?

A. Autonomy
B. Justice
C. Beneficence
D. Non-maleficence

a

11. Which statement by the nurse reflects understanding of appropriate assignment vs. delegation?

A. “I delegated the IV morphine push to the LPN.”
B. “I assigned the LPN to monitor a stable trach patient.”
C. “I asked the UAP to teach incentive spirometry.”
D. “I delegated discharge instructions to the UAP.”

b

12. Which action would most violate a patient’s right to autonomy?

A. Administering pain medication before the patient requests it
B. Starting an IV line after the patient refuses it
C. Calling a rapid response for altered mental status
D. Providing oxygen without patient consent

b

13. Which of the following patients is most appropriate to assign to an experienced LPN?

A. A patient newly diagnosed with diabetic ketoacidosis
B. A patient admitted for seizure activity
C. A patient 2 days post-op with stable vitals and wound care orders
D. A patient requiring complex discharge teaching

c

14. A patient has a living will stating they do not want tube feedings. The provider writes an order for enteral nutrition. What is the nurse's best action?

A. Follow the provider’s order
B. Discuss with the patient’s family
C. Notify the ethics committee
D. Contact the provider for clarification

d

15. A patient refuses surgery after the consent form has been signed. What is the priority actionby the nurse?

A. Tear up the consent form
B. Notify the provider immediately
C. Educate the patient again on the benefits
D. Continue with pre-op procedures

b