Ethics and Clinical Principles in Nursing, Exams of Nursing

Download Ethics and Clinical Principles in Nursing and more Exams Nursing in PDF only on Docsity! 2024 CUMULATIVE 3280 FINAL - WPUNJ (200 QUESTIONS AND ANSWERS)GRADED A PLUS An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? 1. Diagnosis 2. Evaluation 3. Assessment 4. Implementation - SOLUTION 3 A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's: 1. Educator. 2. Advocate. 3. Caregiver. 4. Case manager. - SOLUTION 2. Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion 5. Lobbyist - SOLUTION 1,2,3,4 A nurse meets with the registered dietitian and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics - SOLUTION 3. A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics - SOLUTION 4 What are 3 importances of nursing history? - SOLUTION 1.perspective 2. context 3. past is not repeated 4, Pride 5. enlightening Which nurse was part of the crimean war and pioneer for modern medicine? - SOLUTION Florence Nightingale This person opened the nursing program at St. Thomas Hospital - SOLUTION Florence Nightingale This person founded the American Red Cross - SOLUTION Clara Barton This person founded the American journal of nursing, was the chair of Columbia university and was a big advocate for higher nursing education. - SOLUTION Mary Nutting This person was the pioneer for public health nursing - SOLUTION Lilian Wald This person founded the national association for colored graduate nurses - SOLUTION Mary Mahoney This person founded planned parenthood - SOLUTION Margaret Sanger What are societal ethics? - SOLUTION These are simply laws and regulations that are mandated by the state/ country, that requires all persons at the minimum to follow. What are some of the societal ethics? (name 2 ) - SOLUTION 1. Negligence 2. Liability 3. malpractice 4. Standard of care Choices made at the bedside are an example of what type of ethics? A. Bio ethics B. Professional ethics C. Personal ethics D. Clinical Ethics - SOLUTION D. Clinical Ethics This translates the high standards that are expected because of the privileged role held in society. A. Bio ethics B. Professional ethics C. Personal ethics D. Clinical Ethics - SOLUTION B. This ethics often overlaps with other types of ethics and may have to be put aside to ensure internalized views are not being projected A. Bio ethics B. Professional ethics C. Personal ethics D. Clinical Ethics - SOLUTION C. All of the following are ethical principles except: A. Justice B. Fidelity C. Nonmaleficence D. Respect for self E. Beneficence - SOLUTION D. should be autonomy Select the correct principle of ethics that is being depicted: Cindy is Raymond's nurse. Cindy tells Raymond's the truth about his diagnosis and the likely prognosis for the disease. This is: A. Justice B. Beneficence C. Fidelity D. Respect for person - SOLUTION D. Respect for person in addition to veracity which means telling the truth, respect for person also mean treating each person with respect and dignity. Cindy the nurse on duty noticed that a patient for another nurse who is a fall risk is trying to climb over the rails to get out of bed. She quickly intervenes this is an example of: A. Justice B. Beneficence C. Nonmaleficence D. Respect for person - SOLUTION B. Beneficence is an obligation to do good by acting in ways that promote the welfare and best interests of others Cindy, the nurse for a patient who has a chronic terminal illness reports that he is suffering everyday and wishes that someone would just pull the plug. One night Cindy realizes that no one is around and could easy pull the plug out and back in to end the patient's suffering. If she did this which ethical principle would be compromised? A. Justice B. Beneficence C. Nonaleficence D. Respect for others - SOLUTION C. directs us to act in ways that avoid harm to others, including even the risk of harm ourselves Cindy is treating a homeless man with a deep and severe wound. The patient has not showered in months and has a malodorous scent. She decides that he deserves the same care as everyone else and provides him a bath. this is an example of ? A. Justice B. Beneficence C. Nonaleficence D. Respect for others - SOLUTION A. At a minimum, the principle of justice is concerned with treating people equitably, fairly, and appropriately Cindy has promised to grab new batteries for a patient before she leaves for work. Cindy has a very exhausting shift working 14 hours for the day. Upon packing her things to go, she realized that she forgot the batteries. Cindy should get the patient the battery as this demonstrates: A. Justice B. Beneficence C. Fidelity D. Respect for others - SOLUTION C. Fidelity - In the role of a nurse, such action includes keeping your promises, doing what is expected of you, performing your duties, and being trustworthy The responsibility to do the right thing Is: 1. Ethics of duty 2. Ethics of consequences 3. Ethics of Character 4. Ethics of relationship - SOLUTION 1. Ethics of duty The responsibility to do offer the option that best serve the greater good is: 1. Ethics of duty 2. Ethics of consequences 3. Ethics of Character 4. Ethics of relationship - SOLUTION 2. Ethics of consequences (This basically means, we make decisions that are better for a larger group of people over just an individual, when you see ethic of consequence, think of the consequence of saving one person over a group of people!!) Willingness to reflect on our past action and base decision on our life experiences is: 1. Ethics of duty 2. Ethics of consequences 3. Ethics of Character 4. Ethics of relationship - SOLUTION 3. Ethics of Character (think, of it as, our character makes us who we are). True or false: Whistle blowers are protected when they file legitimate claims about clinical safety? - SOLUTION True True or False: 3. Where to purchase a medical alert bracelet that says she has asthma 4. The importance of maintaining a healthy diet and exercising regularly - SOLUTION 1. A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. Which type of content is the nurse providing? 1. Simulation 2. Restoring health 3. Coping with impaired function 4. Health promotion and illness prevention - SOLUTION 4 A nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of: 1. A teaching plan. 2. A learning objective. 3. Reinforcement of content. 4. Enhancing the children's self-efficacy. - SOLUTION 2 A nurse is instructing a patient who has decreased leg strength on the left side how to use a cane. Which action indicates proper cane use by the patient? 1. The patient keeps the cane on the left side of the body. 2. The patient slightly leans to one side while walking. 3. The patient keeps two points of support on the floor at all times. 4. After the patient places the cane forward, he or she then moves the right leg forward to the cane. - SOLUTION 3 A patient is experiencing some problems with joint stability. The doctor has prescribed crutches for the patient to use while still being allowed to bear weight on both legs. Which of the following gaits should the patient be taught to use? 1. Four-point 2. Three-point 3. Two-point 4. Swing-through - SOLUTION 1. A patient with a right knee replacement is prescribed no weight bearing on the right leg. You reinforce crutch walking knowing that which of the following crutch gaits is most appropriate for this patient? 1. Two-point gait 2. Three-point gait 3. Four-point gait 4. Swing-through gait - SOLUTION 2 Which of the following indicates that additional assistance is needed to transfer the patient from the bed to the stretcher? 1. The patient is 5 feet 6 inches and weighs 120 lbs. 2. The patient speaks and understands English. 3. The patient is returning to unit from recovery room after a procedure requiring conscious sedation. 4. The patient received analgesia for pain 30 minutes ago. - SOLUTION 3 What is moral distress? - SOLUTION A person who is unable to take action that they believe is morally appropriate or is contradicting to their belief What are the three types of patient teaching? - SOLUTION Formal patient education self directed patient-nurse learning What is patient education - SOLUTION assisting people learn health related behaviors so they can incorporate in in their everyday lives What are the three learning domains? - SOLUTION cognitive, psychomotor, affective What are the three attributes necessary for patient education and learning? - SOLUTION Patient will be motivated outcomes should be goal oriented planning is involved These three things often motivate patient's to change their lifestyle to adhere or start treatment: - SOLUTION perception of disease susceptibility to disease severity of the disease Patient got onto to stanford.edu and began looking up material on treatment for leukemia, this is what kind of teaching? - SOLUTION Self directed. It encourages the use of magazines, journals, newspaper and the internet to find information and it is independent of the nurse and other health care professionals Informally, the patient gave the discharge information to the patient so that they could be informed upon leaving the hospital. This is a form of what king of teaching type? - SOLUTION Informal teaching It is not standardized, usually is one-on-one with the nurse and includes things like discharge teaching, wound care, and medication teaching. The patient enrolled in a cancer support group to get help with his recent DX. The - SOLUTION Patient education class. Tell the type of learning domain: The use of one-on-one / group classes - SOLUTION Cognitive Tell the type of learning domain The use of role play and encouraging the patient to express feelings and values : - SOLUTION Affective Tell the type of learning domain The use of return demonstration, demonstration and games - SOLUTION Psychomotor What is care coordination? - SOLUTION It is a set of activities organized by a team to support optimal health care over time Which of the following are part of a care team (select all that apply): 1. Nurse 2. Respiratory Therapist 3. Health Care Provider 4. UAP 5. Patient's mother - SOLUTION all of the above. the patient's family is apart of the care team What are the attributes of care co-ordination? - SOLUTION communication goals A patient is learning how to use a cane. His left leg is the injured leg, on which side does he use the cane? - SOLUTION RIGHT SIDE. remember C.O.A.L - cane opposite affected legq A patient is ascending stairs using partial weight bearing. Select the correct order to ascend. A. Affected leg first, crutches, unaffected leg, repeat. B. Unaffected Leg first, then crutches, affected leg, repeat C. Crutches first, bad leg, good leg, repeat. - SOLUTION B. Up on the good, down on the bad A patient is descending the stairs, using partial weight bearing. Select the correct order to descend. A. Affected leg first, crutches, unaffected leg, repeat. B. Unaffected Leg first, then crutches, affected leg, repeat C. Crutches first, bad leg, good leg, repeat. D. Crutches first, good leg, bad leg, repeat. - SOLUTION C. down with the bad What is the finger width under each crutch? - SOLUTION 3 finger width How often should a client be turned? - SOLUTION Q2 hours A nursing student walks into a room to find a client in bed with four rails up since early in the morning until 9pm at night. How should the student respond? A. Everything is fine. Patient should carry on. B. Student should turn on the TV the patient might be bored C. Student notices this is a restraint and should say soemthing D. Student should perform a bed bath - SOLUTION C. All of the following affect elimination except: A. Age B. Medication C. Fluids and diet D. disease E. all of the above F. None of the above - SOLUTION f. none of the above Nurse Mary secures a restraint to Mr. Curry who is vey combative while he is sedative because last time he woke up earlier than scheduled and attacked the UAP. The nurses's action are A. appropriate in protecting staff B. Inappropriate - SOLUTION B. Patient's who are sedated should not be restrained. What can you recommend for atelectasis prevention for a patient on bed rest - SOLUTION Deep breathing, coughing, use of incentive spirometer What can be done to prevent muscle atrophy and loss of ROM in joints to someone on bed rest? - SOLUTION bed excercises What is urinary frequency? - SOLUTION abnormally frequent voiding What is urinary hesitancy? - SOLUTION A delay and difficulty in initiating voiding What is dysuria? - SOLUTION painful urination What is urinary urge? - SOLUTION leaking a large amount of urine What is transient incontinence? - SOLUTION urinary incontinence resulting from a temporary condition eg. medication or infection. What is impaction? - SOLUTION results from unrelieved constipation; a collection of hardened feces wedged in the rectum that a person cannot expel What are hemorrhoids? - SOLUTION varicose veins in rectum For Elimination, Remember: - SOLUTION Ileostomy = small intestines Colostomy = large intestines (because colost sounds like collosal which means large!) With a walker, does a person move forward with the affected or unaffected leg? - SOLUTION affected leg What three factors do you assess when looking at a urine sample? - SOLUTION COC - Color, Odor, Clarity Is a urinary cauterization a closed or open system? - SOLUTION Closed to prevent back flow and subsequent UTI A nurse is cleaning a patient's bed after she ambulates to use the restroom. The nurse notices that the patient wet her bed. this is called: A. presbyopia B. Enuresis C. Stress incontinence D. Negligence - SOLUTION b. This is another name for bed wetting What is functional incontinence ? - SOLUTION Caused by problems that prevent you from getting to the bathroom in time to avoid an accident (trouble walking from arthritis). What is the maximum the bladder should hold? - SOLUTION 500 cc What position for enema administration? - SOLUTION left side lying with right leg flexed For elimination remember, Elimination: - SOLUTION High Fiber Privacy Fluids Physical Activity Medication What is the number 1 best way to prevent infection and spread of disease? - SOLUTION Hand Hygiene What is the normal range for the follow: 1. PH 2. PA02 3. SaO2 4. HCO2 5. RR - SOLUTION 1. 7.35- 7.45 2. 80 MM HG - 100 MM HG 3. 95%- 100% 4. 22- 266 Meq/ L 5. 12 -20 bpm A. Blistering B. full thickness C. Partial thickness D. open E. closed - SOLUTION A,C,D,E, it is partial thickness, has blistering and can be open or closed For a stage 3 pressure ulcer select all that applies : a. Partial thickness b. Full thickness c. Tunnelling d. adipose tissue exposed e. underlying bone exposed f. depth unknown - SOLUTION B,D in STAGE 3 - no muscle or bone is seen. it is full thickness and doesn't usually have tunelling and the depth IS KNOWN. Name the pressure ulcer: necrotic tissue must be removed before staging - SOLUTION UNSTAGEABLE what are the three phases of wound healing? - SOLUTION inflammation, granulation, maturation What is the normal range of WBC? - SOLUTION 5,000-10,000 Which of the following violates ascetic technique: Select all that apply A. Use for broken skin B. All objects must C. Hands down and scrub well for 20 seconds D. objects must remain in view - SOLUTION A,B,D. Hold hands up when scrubbing. What are the 6 common risk factors of compromised tissue integrity? - SOLUTION Sensory perception Moisture Activity Mobility Nutrition Friction Shearing Based on the following information determine the stage of the pressure ulcer: Has slough, eschar and unable to see depth - SOLUTION unstageable What is a severe score on the Braden scale? - SOLUTION less than 9 What is the time frame for the inflammatory phase? - SOLUTION 3-5 days what is the time frame for granulation phase? - SOLUTION 5 - 21 days (stages 2,3,4,) what is the time frame for maturation phase? - SOLUTION months write true or false for the following airborne precautions: A. Door may be left open B. NEGATIVE AIR needed C. Private room D. microbes are larger than 5mm - SOLUTION A. False (closed at all times) B. True C. True D. False (smaller**) What are the three most common droplet precaution disease? - SOLUTION Pertussis, Influenza and meningitis What PPE is necessary for contact precaution? - SOLUTION gloves and gown Indicate which is true and which is false for contact precaution: A. Must leave equipment within room B. Patient must be limited on time to leave room C.Negative air D. sterile gloves must be worn - SOLUTION A. TRUE B. TRUE C. FALSE (for airborne only) D. False (not necessary) Which of the following require contact precaution? A. C. diff B. MRSA C. Hep A D. Nora Virus/ Rota Virus E. meningitis - SOLUTION A,B,C,D, select ALL WHICH APPLY. Which of the following require hand washing: A. Use of bathroom B. Contact with C.Diff C. soiled hands D. before donning gloves for standard precaution - SOLUTION A,B,C, a small community has noticed for the first time a break out of a virus of a few members in the community this is an example of A. PANDEMIC B. EPIDEMIC C. ENDEMIC - SOLUTION C Today HIV is this type of disease: A. PANDEMIC B. EPIDEMIC C. ENDEMIC - SOLUTION A What is a C&S? and what is it used for ? - SOLUTION culture and sensitivity test. Used to find which treatment will be most effective at treating a disease A patient has a fever and lethargy this is what stage of an infection? - SOLUTION PRODROMAL what is meant by tertiary intention? - SOLUTION wound is large, infected, healing is delayed. E. 2 tbsp = ? ounces? - SOLUTION A. 2.2 B. 15 C. 5 D. 16 E. 1 Complete the conversion table below A. Regular drip = ? gtt B. Micro drip = ? gtt C. 1 cup = ? ounces = ? ml - SOLUTION A. 10 gtt B 60 gtt C. 8 ounces = 240 ml What position should a patient assume when receiving medication for their ear? - SOLUTION Side lying A nurse is about to administer ear medication to a 2 year old child she hold the ear up and back. In 2 weeks the patient comes back without an infection. A. The nurse was proficient in her skill B. The nurse is not proficient - SOLUTION B. the nurse is not proficient. For a child under 3, the ear should be pulled down and back, not up. Before administration of the ear medication what is important to note? - SOLUTION The med should be room temperature as the inner ear is sensitive to temperature and can cause dizziness In what position is eye medication administered? - SOLUTION Supine with hyper extended neck How long should you wait between the first administration of an eye drop and the second eye medication? - SOLUTION 5 minutes All of the following are true of intradermal injections except: A. Bevel point up B. 5 - 15 degrees C. Infuse slowly D. Not advised in children as they may scratch and irritate area - SOLUTION D. This is the most dangerous medication administration. A. Intravenous B. IV bolus C. Large Volume infusion D. IM - SOLUTION Iv Bolus - hits the blood stream quickly and there is not time to correct This types of medication is administered intradermally? A. Insulin B. Heparin C. MMR D. Tuberculin - SOLUTION D Select all that apply. The nurse is able to administer the following subcutaneously A. Insulin B. Heparin C. MMR D. Tuberculin - SOLUTION A, B, C An adult who is 32 years old is to be administered a dose of varicella booster. Where would the nurse administer the shot given no contraindication? A.Ventrogluteal B. Deltoid C. Vastus Lateralis - SOLUTION B. Deltoid. (this is the best place although the others would not be incorrect). Which would require reteaching to the student about to give an immunization IM shot to a child of 2 years old. A. Nurse wiped site before injecting B. Nurse used deltoid muscle C. Nurse distracted child during injection D. Nurse used a bandaid at the end. - SOLUTION B. deltoid is not recommended for child. Which insulin can be given intravenously? - SOLUTION Regular insulin only To administer oral medication what position is best if not contraindicated? - SOLUTION high fowler - 90 degrees What are the SIX rights of a patient: - SOLUTION Right Patient Right Medication Right Dose Right Time Right Route Right documentation What are the four rights of a patient? - SOLUTION Right to refuse Right to education Right to assessment Right to evaluation What demonstrates a positive PPD test? - SOLUTION 10 mm What is the optimal blood glucose ? - SOLUTION 70-100 mg/dL the study of drug movement throughout the body - SOLUTION Pharmacokinetics THE STUDY OF THE ACTION OR EFFECTS OF MEDICATIONS ON LIVING ORGANISMS - SOLUTION This is pharmacodynamics? A patient is given amoxillin for an infection. within a few days later the patient is cured of the infection this is an example of: A. Adverse Effect B. Therapeutic Effect C. Medication Interaction - SOLUTION B A patient is administered Clonidine and Propranolol. The patient notices that after taking the second drug a severely slowed heart rate this is an example of A. Adverse Effect B. Therapeutic Effect C. Medication Interaction - SOLUTION C A patient is administered aspirin for a headache. Upon taking the pill, the patient goes into anaphylactic shock this is an example of: