Deck 3: Issues in Nursing Practice

Question 1

The nurse is caring for a patient receiving morphine who states the morphine is no longer working. The nurse notifies the health care provider and requests that an increase in dosage or a different medication be given. Which of these is the nurse demonstrating?

A)Advocacy
B)Paternalism
C)Confidentiality
D)Veracity

Answer 1

Advocacy

Question 2

The nursing staff is meeting to discuss a patient's desire for all life support measures, even though the patient has end-stage renal disease. Once a list of all possible actions is generated, what should the staff do next?

A)List the stakeholders.
B)Determine the best action.
C)Gather important information.
D)Identify positive and negative consequences.

Answer 2

Identify positive and negative consequences.

Question 3

A nurse manager has to make a decision about scheduling and asks the nurses on the unit before making a decision. This demonstrates which style of leadership?

A)Autocratic
B)Democratic
C)Laissez-faire
D)Coaching

Answer 3

Democratic

Question 4

Which action by the nurse demonstrates adherence to the Health Insurance Portability and Accountability Act (HIPAA)?

A)Taking a photo of a patient for Instagram
B)Logging out of a computer after documenting patient care
C)Discussing a patient's status with a friend
D)Posting details about the patient without using the name on Facebook

Question 5

The nurse is caring for a patient newly admitted and notes a stage III pressure ulcer. For the hospital to receive payment for services rendered for this patient, which action must the nurse take?

A)Notify the patient's insurance of the pressure ulcer.
B)Document the ulcer and interventions provided.
C)Be careful not to mention the ulcer in documentation.
D)Tell the patient his care will not be covered by insurance.

Question 6

A health care administrator is reviewing material submitted to the legislature on tort reform. What should the administrator explain to nurse leaders about this legislation?

A)Limits organizational liability for damages
B)Requires continuing education for all caregivers
C)Expects all staff to have read organizational policies before completing procedures
D)Expects all staff to have malpractice or liability insurance

Question 7

The LPN/LVN is contemplating whether delegation is appropriate. Which would help the LPN/LVN make this decision?

A)Patient's bill of rights
B)Nurse practice act
C)Facility policy and procedure manual
D)Joint Commission guidelines

Question 8

A patient with malnutrition refuses to ingest animal protein products, because it is against religious teachings. What should the nurse do to support this patient's beliefs while ensuring the patient's health status?

A)Explain the animal protein is the best source of nutrition for the patient's needs at this time.
B)Talk with a dietitian about sources of non-animal-based protein to include in the patient's diet.
C)Suggest to the physician that the patient is going against medical advice and should be discharged.
D)Schedule the organization's clergy to meet with the patient to discuss interpretation of religious teachings.

Question 9

The nurse is informed of several victims of gang violence being brought by ambulance to the emergency department. Which injury should the nurse prepare to report to the authorities?

A)Fractures
B)Abrasions
C)Lacerations
D)Gunshot wounds

Question 10

During a patient care conference, the health care providers (HCPs) are reviewing potential outcomes based on individual interventions. Which bioethical theory is being demonstrated during this care conference?

A)Religion
B)Deontology
C)Theological
D)Utilitarianism

Question 11

The nurse is assessing an unresponsive older adult who lives with her daughter and notes multiple pressure ulcers and bruises all over. Which action by the nurse is most appropriate?

A)Call the daughter and tell her if the abuse doesn't stop you will call the police.
B)Notify the authorities of suspected abuse.
C)Contact a nursing home to see if she will accept the patient.
D)Do not get involved in a suspected abuse case.

Question 12

The nurse is caring for a patient with liver failure who is unconscious. The patient's girlfriend of 12 years has been making health care decisions. The patient is still legally married, and his wife whom he has not seen in 20 years shows up and wants to take over in making medical decisions. Which action should the nurse take?

A)Provide care according to the girlfriend's wishes.
B)Ask the charge nurse to assign another nurse to care for the patient.
C)Ask for an ethics committee consult.
D)Ignore both parties and provide care based on the nurse's own values.

Question 13

Which task is most appropriate for the licensed practical nurse/licensed vocational nurse (LPN/LVN) to delegate to the unlicensed assistive personnel (UAP)?

A)Changing the dressing of a patient who had abdominal surgery
B)Ambulating a patient who just underwent knee surgery
C)Assessment of a newly admitted patient
D)Feeding a patient who needs assistance with eating

Question 14

The nurse is caring for a patient who begins to exhibit difficulty swallowing. Which discipline will the nurse likely include in the patient's care?

A)Occupational therapist
B)Respiratory therapist
C)Social worker
D)Speech pathologist

Question 15

An LPN/LVN delegates oral care to a UAP. The patient never receives the oral care. Who is held accountable?

A)The nurse manager
B)The charge nurse
C)The UAP
D)The LPN/LVN

Question 16

The nurse is caring for a patient with end-stage renal failure who wishes to stop dialysis treatment. Which response by the nurse is best?

A)"You will die if you do not continue dialysis."
B)"I respect your decision and will let your doctor know."
C)"You need to consider your family when making your decision."
D)"I think you should continue dialysis for a few more weeks."

Question 17

Before leaving a patient's room, the nurse says that pain medication will be provided within 15 minutes. The nurse returns in 10 minutes with the pain medication. Which ethical principle did the nurse demonstrate?

A)Justice
B)Fidelity
C)Veracity
D)Beneficence

Question 18

The nurse is caring for a famous actor. The press approaches the nurse leaving work and asks about the actor. What is the most appropriate response by the nurse?

A)"I will ask the actor to call you and give you an update."
B)"The actor has severe pneumonia and will be placed on a ventilator."
C)"I cannot release any information due to patient confidentiality."
D)"All I can say is the actor is a patient here and he is stable."

Question 19

The nurse suspects a patient is a victim of human trafficking. Which characteristic supports this suspicion?

A)The individual has a man with her who answers all questions for her and will not leave the room.
B)The patient is talkative and makes eye contact.
C)The patient is calm and answers questions.
D)The patient tells the nurse she is stressed because she owns a chain of restaurants.

Question 20

The nurse notices a colleague place a hydrocodone tablet in their pocket prior to leaving the hospital. Which action should the nurse take?

A)Confront the coworker about what the nurse saw.
B)Ask an RN what to do.
C)Notify the nurse manager of the unit.
D)Call the police and report the incident.

Question 21

The nurse is planning to prepare medications for assigned patients. Which actions should the nurse take to ensure a safe environment while preparing the medications? (Select all that apply.)

A)Find a laboratory value for a physician as requested.
B)Place a "no interruption sign" on the door of the medication room.
C)Answer a patient's call light after checking the medication administration record.
D)Listen to information provided by the charge nurse about a newly admitted patient.
E)Ask coworkers to provide you with time to concentrate while preparing medication.

Question 22

The LPN is working in a senior center and is approached by a participant who asks the nurse, "Can you help me understand my Medicare benefits?" What should the nurse include in a response to this patient? (Select all that apply.)

A)"Medicare is a payment system for the working poor."
B)"Medicare Part B covers outpatient services and has a monthly cost."
C)"Medicare is a federally funded program for individuals 65 and over."
D)"Prescription drug coverage for those with Medicare is available."
E)"Medicare Part A covers inpatient hospital care and is free to those who qualify for Social Security."

Question 23

The nurse is preparing to delegate a task to the UAP. Which actions should the nurse take in compliance with the National Council of State Boards of Nursing's (NCSBN) rights of delegation? (Select all that apply.)

A)Right day
B)Right place
C)Right person
D)Right supervision
E)Right circumstances
F)Right communication

Question 24

Which of the following must be reported to the state board of nursing? (Select all that apply.)

A)Address changes
B)Number of individuals in household
C)Location of employment
D)Conviction occurring in any state
E)Student loan debt

Question 25

Place in order, from 1 to 8, the steps to process an ethical dilemma. ___

A) Determine the best action with the strongest ethical support.
B) Gather and verify the information.
C) Implement the action.
D) Examine possible actions and the consequences of each action.
E) Identify the ethical dilemma. ___
F) Determine the ethical foundation for each action.
G) Identify the stakeholders and their values.
H) Evaluate the outcome.

Question 26

A nurse is working on a medical unit in a hospital undergoing a Joint Commission review. The investigator asks the nurse to explain "never events." What examples should the nurse use to explain these kinds of events? (Select all that apply.)

A)Surgery on the wrong body part
B)Paralyzed leg after falling from a bed
C)Death from falling out of bed
D)Having to restart an IV infusion
E)Canceling surgery because blood work is not safe

Question 27

Place in order, from 1 to 5, the five major components in the management process. __

A) Coordinating __
B) Organizing __
C) Planning __
D) Controlling __
E) Directing