PNC Final Exam Verified Questions And Answers With Latest Solutions

1. Well-defined body of specific and unique knowledge 2. Strong service orientation 3. Recognized authority by a professional group 4. Code of ethics 5. Professional organization that sets standards 6. Ongoing research 7. Autonomy and self-regulation - ANS-Note the seven characteristics that qualify an occupation as a profession. Standard 1. Assessment Standard 2. Diagnosis Standard 3. Outcomes Identification Standard 4. Planning Standard 5. Implementation Standard 5a. Coordination of Care Standard 5b. Health Teaching and Promotion Standard 5c. Consultation Standard 5d. Prescriptive Authority and Treatment Standard 6. Evaluation Standard 7. Ethics Standard 8. Education Standard 9. Evidence-Based Practice and Research Standard 10. Quality of Practice Standard 11. Communication Standard 12. Leadership Standard 13. Collaboration Standard 14. Professional Practice Evaluation Standard 15. Resource Utilization Standard 16. Environmental Health Standard 17. Collegiality - ANS-List the 17 aspects that comprise the ANA Code of Ethics and Scope of Practice Standards. 1. The state practice act must permit delegation and outline the authorized task(s) to be delegated or authorize the RN to decide delegation. 2. The person making the delegation has the appropriate qualifications 3. The person receiving the delegation must have the appropriate qualifications - ANS-There are three criteria to be considered by the RN when deciding to delegate care activities. List these criteria. 1. The initial and ongoing nursing assessment of the patient and the patient's nursing care needs 2. The determination of the nursing diagnosis, nursing care plan, evaluation of the patient's progress in relation to the care plan, and evaluation of the nursing care delivered to the patient 3. The supervision and education of nursing personnel; patient teaching that requires an assessment of the patient and the patient's education needs 4. Any other nursing intervention that requires professional nursing knowledge, judgment, and/or skill - ANS-Note nursing care or tasks that should never be delegated except to another RN. 1. Right task 2. Right circumstances 3. Right person 4. Right direction/communication 5. Right supervision - ANS-What are the Five Rights of Delegation? Systematic: --Each nursing activity is part of an ordered sequence of activities. Dynamic: --There is great interaction and overlapping among the five steps. Interpersonal: --The nursing process ensures that nurses are person centered rather than task centered Outcome Oriented: --The patient benefits from continuity of care, and each nurse's care moves the patient closer to outcome achievement. Universally Applicable in Nursing Situations: --When nurses have a working knowledge of the nursing process, they find that they can practice nursing with well or ill people, young or old, in any type of practice setting. - ANS-Describe the 5 Characteristics of the Nursing Process. Assessing - ANS-A term for the collection, validation, and communication of patient data Diagnosing - ANS-A term for the analysis of patient data to identify patient strengths and health problems that independent nursing intervention can prevent or resolve Outcome Identification and Planning - ANS-Terms for the specification of (1) patient outcomes to prevent, reduce, or resolve the problems identified in the nursing diagnoses; and (2) related nursing interventions Implementing - ANS-A term for carrying out the plan of care Evaluating - ANS-A term for measuring the extent to which the patient has achieved the outcomes specified in the plan of care; identifying factors that positively or negatively influenced outcome achievement; revising the plan of care if necessary As two-part statements listing the patient's problem and it's etiology -OR- Three-part statements that also include the problem, it's etiology, and defining characteristics - ANS-How are most nursing diagnoses written? Phrase the nursing diagnosis as a patient problem or alteration in health state rather than as a patient need. Check to make sure that the patient problem precedes the etiology and that the two are linked by the phrase "related to." Defining characteristics, when included in the nursing diagnosis, should follow the etiology and be linked by the phrase "as manifested by" or "as evidenced by." Write in legally advisable terms. Use nonjudgmental language. Be sure the problem statement indicates what is unhealthy about the patient or what the patient wants to change (enhance). Avoid using defining characteristics, medical diagnoses, or something that cannot be changed in the problem statement. - ANS-Note considerations to utilize when forming nursing diagnoses. Actual Risk Possible Wellness Syndrome - ANS-Note the five types of nursing diagnoses. Actual Nursing Diagnoses - ANS-These nursing diagnoses represent problems that have been validated by the presence of major defining characteristics. This type of nursing diagnosis has four components: label, definition, defining characteristics, and related factor. Risk Nursing Diagnoses - ANS-These nursing diagnoses are clinical judgments that a person, family, or community is more vulnerable to develop the problem than others in the same or similar situation. Possible Nursing Diagnoses - ANS-These nursing diagnoses are statements describing a suspected problem for which additional data are needed. Additional data are used to confirm or rule out the suspected problem. Wellness Diagnoses - ANS-These nursing diagnoses are clinical judgments about a person, group, or community in transition from a specific level of wellness to a higher level of wellness. These diagnoses are often more applicable in nursing settings that deal primarily with healthy patients. The diagnostic statement is a one-part statement that contains the label Readiness for Enhanced, followed by the desired higher-level wellness. 1. A desire for a higher level of wellness 2. An effective present status or function - ANS-What two cues must be present for a valid wellness diagnosis? Syndrome Nursing Diagnoses - ANS-These nursing diagnoses comprise a cluster of actual or risk nursing diagnoses that are predicted to be present because of a certain event or situation. Utilitarian. - ANS-What ethical form is described as: The rightness or wrongness of an action depends on the consequences of the action. Deontologic - ANS-What ethical form is described as: An action is right or wrong based on a rule, independent of its consequences. 1. It is a succinct statement of the ethical obligations and duties of every individual who enters the nursing profession. 2. It is the profession's nonnegotiable ethical standard. 3. It is an expression of nursing's own understanding of its commitment to society. - ANS-The Code of Ethics for Nurses serves the following purposes: 1. Nurses and People 2. Nurses and Practice 3. Nurses and the Profession 4. Nurses and Co-Workers - ANS-The ICN Code of Ethics for Nurses has four principal elements that outline the standards of ethical conduct. Note these four principal elements. Autonomy/Self-Determination - ANS-A term for respecting the rights of patients or their surrogates to make health care decisions. Nonmaleficence - ANS-A term for the avoidance of causing harm Beneficence - ANS-A term for being of benefit to the patient, and balancing benefits against risks and harms. Justice - ANS-A term to describe giving each his or her due; acting fairly. Fidelity - ANS-A term for keeping promises As intentional or unintentional acts of wrongdoing - ANS-How may torts be broadly classified? 1. Assault and Battery 2. Defamation of Character 3. Invasion of Privacy 4. False Imprisonment 5. Fraud - ANS-Note the 5 intentional tort categories. Intentional Tort - ANS-A person committing this type of tort is considered to have knowledge of the permitted legal limits of his or her words or acts. Violating these limits is grounds for prosecution. Unintentional - ANS-These types of torts are referred to as negligence. Assault and Battery - ANS-This type of tort refers to a threat or an attempt to make bodily contact with another person without that person's consent. Defamation of Character - ANS-This type of tort occurs wherein which one party makes derogatory remarks about another that diminish the other party's reputation. Slander is spoken form, while libel is the written form. This tort type is grounds for an award of civil damages. Damages are awarded to the plaintiff based on the amount of harm done to the plaintiff. Invasion of Privacy - ANS-This type of tort includes: Unnecessary exposure of patients while moving them through a corridor or while caring for them in rooms they share with others Talking with patients in rooms that are not soundproof Discussing patient information with people not entitled to the information Pressing the patient for information not necessary for care planning Interacting with the patient's family in ways not authorized by the patient Using tape recorders, dictating machines, computers, and the like without taking precautions to ensure the patient's confidentiality Preparing written or oral class assignments about patients without concealing their identity Carrying out research without taking proper precautions to ensure the anonymity of patients Punishments for anyone caught in this tort include: Fines of up to $250,000 Jail for up to 10 years. Penalties and embarrassment for your and your workplace False Imprisonment - ANS-This type of tort involves the unjustified retention or prevention of the movement of another person without proper consent. Additionally the indiscriminate and thoughtless use of restraints on a patient can constitute this tort. Fraud - ANS-This type of tort is the willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Misrepresentation of a product is a common fraudulent act. A person misrepresenting oneself to obtain a license to practice nursing may be prosecuted under the state's Nurse Practice Act. Also, misrepresenting the outcome of a procedure or treatment may constitute this tort. Negligence and Malpractice - ANS-This type of tort is defined as performing an act that a reasonably prudent person under similar circumstances would not do or, conversely, failing to perform an act that a reasonably prudent person under similar circumstances would do. Malpractice - ANS-This is the term generally used to describe negligence by professional personnel. 1. Failure to follow standards of care 2. Failure to use equipment in a responsible manner: 3. Failure to assess and monitor 4. Failure to communicate 5. Failure to document 6. Failure to act as a patient advocate or to follow the chain of command - ANS-Identify the 6 common categories of malpractice claims: Duty Breach of Duty Causation Damages - ANS-Liability involves four elements that must be established to prove that malpractice or negligence has occurred. Identify these elements. Duty - ANS-A term that refers to an obligation to use due care (what a reasonably prudent nurse would do) and is defined by the standard of care appropriate for the nurse-patient relationship. Breach of Duty - ANS-A term for the failure to meet the standard of care. Causation - ANS-A term for the most difficult element of liability to prove, shows that the failure to meet the standard of care (breach) actually caused the injury. Damages - ANS-A term for the actual harm or injury resulting to the patient. The Standard of Care—what a reasonably prudent person would or would not have done under similar circumstances - ANS-Whether negligence has occurred depends on what? Public Health Activities -Tracking and notification of outbreaks -Infection control -Stats related to problems with drugs or equipment -Medical records crucial to crime investigation -ID victims of crime or disasters -Report cases of child abuse, neglect, domestic violence -Valid subpoena -Needed by coroners, medical examiners, funeral directors -Organ donations -Law enforcement in case of death from crime Law Enforcement and Judicial Proceedings Deceased People - ANS-List the components of and situations when breaches in health information are acceptable Incidental Disclosure of PHI - ANS-A term defined as a secondary disclosure that cannot reasonably be prevented, is limited in nature, and occurs as a byproduct of an otherwise permitted use or disclosure of PHI. Use of sign-in sheets The possibility of a confidential conversation being overheard Placing patient charts outside exam rooms Use of white boards X-ray light boards that can be seen by passers-by Calling out names in the waiting room Leaving appointment reminder voicemail messages - ANS-Note 6 Examples of incidental disclosures that are permitted. Competent Practice Informed Consent or Refusal Contracts Collective Bargaining