NEWEST NR 226 ACTUAL FINAL Exam 1 WITH MULTIPLE QUESTIONS AND ANSWERS 100% RATED CORRECT WITH 100% SURE PASS|GRADED A+

NEWEST NR 226 ACTUAL FINAL Exam 1 WITH MULTIPLE QUESTIONS AND ANSWERS 100% RATED CORRECT WITH 100% SURE PASS|GRADED A+ A practitioner asks the nurse to witness an informed consent. Which patient does the nurse identify is unable to give an informed consent for surgery? 1) 16 year old boy who is married 2) 35 year old woman who is depressed 3) 50 year old woman who does not speak English 4) 65 year old man who has received a narcotic for pain. Correct Answer: 4 (Narcotics depress the CNS, including decision-making abilities. 1 - Because legally anyone under 18 who is married can make the decision. 2 - wrong because a depressed person can make these decisions until proven mentally incompetent. 3 - Wrong because this person can provide informed consent after translations. When the nurse is administering a medication to a confused patient, the patient says, "this pill looks different from the one I had before." What should the nurse do? 1) Ask what the other pill looked like. 2) Explain the purpose of the medication. 3) Check the original medication prescription. 4) Encourage the patient to take the medication. Correct answer: 3 (This is the safest intervention because it goes to the original source of the prescription.) 1 - Wrong because This action by itself is unsafe because the patient is confused and the information obtained may be innacurate. 2 - This intervention ignores the patient's concern. 4 - This action ignores the patient's statement and is unsafe without obtaining additional information. The nurse administers an incorrect dose of a medication to a patient. What is the primary purpose of documenting this event in an Incident Report? 1) Record the event for future litigation. 2) Provide a basis for designing new policies. 3) Prevent similar situations from happening again. 4) Ensure accountability for the cause of the accident. Correct answer: 3 (Risk-management committees use stats about accidents & incidents to identify patterns of risk and prevent future accidents/incidents.) 1 - Wrong because although documentation of an incident may be used in a court of law, it is not the primary reason for an incident report. 2- This is not the primary reason. New policies may or may not have to be written and implemented. 4 - Although nurses are always accountable for their actions, accountability for the cause of an incidence is the role of the courts. A practitioner writes a prescription for a medication that is larger than the standard dose. What should the nurse do? 1) Inform the supervisor 2) Give the drug as prescribed. 3) Give the average dose of the medication. 4) Discuss the prescription with the practitioner. Correct Answer: 4 (Nurses have a prof. resonsibility to know/investigate the standard dose for medications being administered. In addition, nurses are responsible for their own actions regardless of whether there is a written prescription) 1 - It is unnecessary to call the supervisor. 2 - This is unsafe for the patient and may result in malpractice. 3 - Changing a medication prescription is not within the scope of nursing practice. When the nurse attempts to administer a medication to a patient, the patient refuses to take the medication because it causes diarrhea. The nurse provides teaching about the medication, but the patient continues to adamantly refuse the medication. What should the nurse do first? 1) Document the patient's refusal to take the medication. 2) Notify the practitioner of the patient's refusal to take the medication. 3) Discuss with a family member the need for the patient to take the medication. 4) Explain again to the patient the consequences of refusing to take the medication. Correct Answer: 1 (The patient has the right to refuse) 2. Notifying the practitioner eventually should be done, but it is not the priority at this time. 3. Discussing the situation with a family member without the patient's consent is a violation of confidentiality. 4. The patient has been taught about the medication and adamantly refuses the medication. Further teaching at this time may be viewed by the patient as badgering. When caring for a terminally ill patient, a family member says, "I need your help to hasten my mother's death so that she is no longer suffering." What should the nurse do based on the position of the American Nurse association in relation to assisted suicide? 1) Not participate in active euthanasia. 2) Participate based on personal values and beliefs. 3) Participate when the patient is experiencing severe pain. 4) Not participate unless two practitioners are consulted and the patient has had counseling. Correct Answer: 1 (Withholding the medication and docu- menting the patient's refusal are the appropriate interventions. Patient's have a right to refuse care.) 2. Notifying the practitioner eventually should be done, but it is not the priority at this time. 3. Discussing the situation with a family member without the patient's consent is a violation of confidentiality. 4. The patient has been taught about the medication and adamantly refuses the medication. Further teaching at this time may be viewed by the patient as badgering. Which organization is responsible for ensuring that Registered Nurses are minimally qualified to practice nursing? 1) Sigma Theta Tau 2) State Boards of Nursing 3) American Nurses Association 4) Constituent leagues of the National League for Nursing. Correct Answer: 2. (The National Council of State Boards of Nursing is responsible for the NCLEX examinations; however, the licensing authority in the jurisdiction in which the graduate takes the examination verifies the acceptable score on the examination.) 1. Sigma Theta Tau, the international honor society of nursing, recognizes academic achievement and leadership qualities, encourages high professional standards, fosters creative endeavors, and supports excellence in the profession of nursing. This organization does not grant licensure. 3. The American Nurses Association (ANA) is the national professional organization for nursing in the United States. It fosters high standards of nursing practice; it does not grant licensure. 4. The National League for Nursing (NLN) is committed to promoting and improving nursing service and nursing education; it does not grant licensure A nurse expert is called to testify in a lawsuit regarding professional nursing malpractice primarily to testify: 1. About standards of nursing care as they apply to the facts in the case 2. With regard to laws governing the practice of nursing 3. For the prosecution 4. For the defense Correct Answer: 1 (The American Nurses Association Standards of Clinical Nursing Practice are authoritative statements by which the national organization for nursing describes the responsibilities for which its practitioners are accountable. An expert nurse is capable of explaining these standards as they apply to the situation under litigation. These professional standards are one criterion that helps a judge or jury determine if a nurse committed malpractice or negligence.) 2. An expert nurse is not an expert in the law. The expert nurse's role is not to make judgments about the laws as they apply to the practice of nursing. 3. A nurse expert can testify for either the prosecution or the defense. 4. A nurse expert can testify for either the defense or the prosecution. The nurse initiates a visit from a member of the clergy for a patient. How is the nurse functioning when initiating this visit? 1. Interdependently 2. Independently 3. Dependently 4. Collegially Correct Answer: 2 (The nurse is initiating the referral to the member of the clergy and is therefore working independently. Nurses are legally permitted to diagnose and treat human responses to actual or potential health problems.) 1. The nurse does not need a practitioner's order to make a referral to a member of the clergy. An interdependent intervention requires a practitioner's order associated with a parameter. 3. This action is within the scope of nursing practice. The nurse does not need a practitioner's order to make a referral to a member of the clergy. 4. The nurse can make a referral to a mem- ber of the clergy without collaborating with another professional health-care team member. A patient is asked to participate in a medical research study. The nurse describes to the patient and family members how the patient is protected by the: 1. Code of Ethics 2. Informed Consent 3. Nurse Practice Act 4. Constitution of the United States Correct Answer: 2 (Informed consent is an agreement by a client to accept a course of treatment or a procedure after receiving complete information necessary to make a knowledgeable decision.) 1. A code of ethics is the official statement of a group's ideals and values. It includes broad statements that provide a basis for professional actions. 3. Nurse Practice Acts define the scope of nursing practice; they are unrelated to informed consent. 4. The Constitution of the United States addresses broad individual rights and responsibilities. The rights related to nursing practice and patients include therights of privacy, freedom of speech, and due process. The nurse is implementing an ordered bowel preparation for a patient who is scheduled for a colonoscopy. Which is the most serious consequence that is prevented by an effective bowel preparation? 1. Discomfort 2. Misdiagnosis 3. Wasted expense 4. Psychological stress Correct Answer: 2 (Fecal material in the intestines can interfere with the visualization, collection, and analysis of data obtained through a colonoscopy, resulting in diagnostic errors.) 1. Although this may occur, it is not the most serious outcome of an inappropriate preparation for a colonoscopy. 3. A test may have to be cancelled or per- formed a second time if the patient has an ineffective bowel preparation. Although this is a serious consequence, it is not life threatening. 4. Although this is a serious consequence, it is not life threatening. The practitioner orders OOB for a patient. How is the nurse functioning when moving this patient out of bed to a chair? 1. Dependently 2. Independently 3. Collaboratively 4. Interdependently Correct Answer: 1 (Determining the extent of activity desirable for a patient is within the practitioner's, not a nurse's, scope of practice. Following activity orders is a dependent function of the nurse.) 2. The responsibility to determine a patient's activity level is not within the legal scope of nursing practice. 3. A practitioner works independently when determining a patient's desired activity level. 4. The nurse is following the practitioner's order to get the patient OOB. There are no restrictions or parameters in relation to the order. However, the nurse must use judgment before, during, and after a transfer if a patient's condition changes. A Registered Nurse witnesses an accident and assists the victim who has a life-threatening injury. What should the nurse do to meet the most important standard when acting as a Good Samaritan at the scene of an accident? 1. Seek consent from the injured party before rendering assistance 2. Implement every critical-care intervention necessary to sustain life 3. Stay at the scene until another qualified person takes over responsibility 4. Insist on helping because a nurse is the best-qualified person to provide care Correct Answer: 3. When a nurse renders emergency care, the nurse has an ethical responsibility not to abandon the injured person. The nurse should not leave the scene until the injured person leaves or another qualified person assumes responsibility. 1. Depending on the injured person's physi- cal and emotional status, the person may or may not be able to consent to care. 2. When a nurse helps in an emergency, the nurse is required to render care that is consistent with care that any reasonably prudent nurse would provide under simi- lar circumstances. The nurse should not attempt interventions that are beyond the scope of nursing practice. 4. A nurse should offer assistance, not insist on assisting, at the scene of an emergency. A faculty member of a nursing program is conducting an informational session for potential nursing students. The faculty member includes the information that at the completion of the program licensure to practice is: 1. A responsibility of the American Nurses Association 2. Granted on graduation from a nursing program 3. Approved by the National League for Nursing 4. Required by state law Correct Answer: 4. The Nurse Practice Act in a state stipulates the requirements for licensure within the state. 1. The ANA Standards of Clinical Nursing Practice do not address licensure. 2. When a person graduates from a school of nursing, the individual receives a diploma that indicates completion of a course of study; the diploma is not a license to practice nursing. 3. The National League for Nursing (NLN) promotes nursing service and nursing education; it is not involved with licensure. When considering legal issues the word contract is to liable as standard is to: 1. Rights 2. Negligence 3. Malpractice 4. Accountability Correct Answer: 4. Liable means a person is responsible (accountable) for fulfilling a contract that is enforceable by law. Accountable means a person is responsible (liable) for meeting standards, which are expectations established for making judgments or comparisons. 1. Although patients have a right to receive care that meets appropriate standards, the word right does not have the same relationship to the word standard as the relationship between the words contract and liable. 2. The words standards and negligence do not have the same relationship as contract and liable. Negligence involves an act of commission or omission that a reasonably prudent person would not do. 3. The words standards and malpractice do not have the same relationship as contract and liable. Malpractice is negligence by a professional person. An anxious patient repeatedly uses the call bell to get the nurse to come to the room. Finally the nurse says to the patient, "If you keep ringing, there will come a time I won't answer your bell." What legal term is related to this statement? 1. Slander 2. Battery 3. Assault 4. Libel Correct Answer: 3. This is an example of assault. Assault is a verbal attack or unlawful threat causing a fear of harm. No actual contact is necessary for a threat to be an assault. 1. This is not an example of slander, which is a false spoken statement resulting in damage to a person's character or reputation. 2. This is not an example of battery, which is the unlawful touching of a person's body without consent. 4. This is not an example of libel, which is a false printed statement resulting in damage to a person's character or reputation. The nurse is informed that a credentialing team has arrived and is in the process of assessing quality of care delivered at the hospital. What is the organization associated with the credentialing of hospitals? 1. Joint Commission 2. National League for Nursing 3. American Nurses Association 4. National Council Licensure Examination Correct Answer: 1. The Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) evaluates health-care organizations' compliance with Joint Commission standards. Accreditation indicates that the organization has the capabilities to provide quality care. In addition, federal and state regulatory agencies and insurance companies require Joint Commission accreditation. 2. The National League for Nursing (NLN) fosters the development and improvement of nursing education and nursing service. 3. The American Nurses Association (ANA) is the national professional organization for nursing in the United States. Its purposes are to promote high standards of nursing practice and to support the educational and professional advancement of nurses. 4. In the United States, graduates of educa- tional programs that prepare students to be- come Licensed Practical Nurses or Registered Professional Nurses must successfully complete the National Council Licensure Examination-PN (NCLEX-PN) and the National Council Licensure Examination-RN (NCLEX-RN), respectively, as part of the criteria for licensure. A student nurse is about to graduate from an accredited nursing program. The student nurse understands that an action unrelated to a state Nurse Practice Act is: 1. Setting guidelines for nurses' salaries in the state 2. Establishing reciprocity for licensure between states 3. Determining minimum requirements for nursing education 4. Maintaining a list of nurses who can legally practice in the state Correct Answer: 1. State Nurse Practice Acts define and regulate the practice of nursing within the state. The salary of nurses is determined through negotiations between nurses or their representatives, such as a union or a professional nursing organization, and the representatives of the agency for which they work. 2. A state's Nurse Practice Act determines the criteria for reciprocity for licensure. 3. A state's Nurse Practice Act stipulates minimum requirements for nursing education. 4. A state's Nurse Practice Act defines the criteria for licensure within the state. The actual functions, such as maintaining a list of nurses who can legally practice in the state, may be delegated to another official body such as a State Board of Nursing or State Education Department.