Nursing Instructions and Decision Making Scenarios, Exams of Nursing

Download Nursing Instructions and Decision Making Scenarios and more Exams Nursing in PDF only on Docsity! ASSESSMENT LEADERSHIP AND COMMUNITY HEALTH 1. An occupational health nurse is preparing to teach a health promotion class for workersat a warehouse. Which of the following statements should the nurse include? "Rub your hands together for at least 10 seconds when washing them.""Keep your abdominal muscles tightened when lifting objects." "Ensure that 20 percent or less of calories are from saturated fats." "Engage in aerobic exercise 2 to 4 days per week for 20 min." 2. A nurse is preparing an in-service about family violence for a group of newly licensednurses. Which of the following statements should the nurse include in the teaching? "Perpetrators of family-directed violence recognize their behavior as abnormal." "Female clients who experience partner violence are at greater risk for acute diseases.""The victim's risk for homicide is greatest when they decide to leave the relationship.""The level of violence of the events decreases over time." 3. A community health nurse is reviewing primary prevention strategies for West Nile viruswith a group of clients in a rural health clinic. Which of the following instructions shouldthe nurse include? Avoid exposure to deer ticks. Eliminate areas of standing water. Use a respiratory mask when cleaning bird coops.Plan outdoor activities after dusk 8. A nurse manager is teaching a group of employees about standards for Quality and SafetyEducation for Nurses (QSEN). Which of the following statements by an employee shouldthe nurse manager identify as an example of the QSEN concept of quality improvement? "We should start tracking how soon clients are discharged after laparoscopic versus opensurgery." "We should be sure to log out of the computers immediately following documentation.""We should involve our clients' partners in care planning as much as possible." "We should provide change-of-shift report as a team, including the assistive personnel whoassisted with care. 9. A hospice nurse is providing teaching to a client who has a new diagnosis of a terminal illness and her family. Which of the following statements should the nurse include in theteaching? "Hospice care focuses on disease treatment and rehabilitation." "The provider will coordinate your health care needs while in hospice." "You must choose a family caregiver before being admitted into a hospice facility.""Hospice care continues to help families with grief after a death occurs." 10. A nurse manager is discussing electronic medical records with a newly licensed nurse. Which of the following actions should the nurse take to maintain client confidentiality?(Select all that apply.) Log out of the computer terminal before leaving. Share passwords for computer access with colleagues.Change computer access passwords on a regular basis. Avoid accessing information about clients admitted to other units.Shred computer-generated client worksheets after use. 11. A nurse is completing an assessment of a recently widowed older adult client. He stateshe is unable to drive and is afraid to cook on the stove. Which of the following community resources should the nurse recommend? Hospice care Meals on Wheels Home health services Posting the name of the nurse providing care on a client's communication boardDiscussing the client's new medication with a hospital pharmacist Faxing requested medical information for a client who is transferring to another facilityEmailing the client's positive hepatitis results from an unencrypted serve 13. A nurse manager is preparing to complete staff performance appraisals. Which of the following principles should the nurse manager consider when completing the appraisals? Performance appraisals should be written in measurable terms. Appraisal objectives should be applicable to staff at every level. Performance appraisals should be based on the nurse manager's preferences.Completed appraisals should be approved by a provider. 14. A nurse is caring for a client and realizes they have administered the wrong medication.Which of the following actions should the nurse take first? Notify the provider. Check the condition of the client. Document the occurrence in the electronic medical record.Complete an incident report. 15. A nurse is caring for a newborn in the nursery following a circumcision. The newborn's grandparent, who does not have an identication bracelet, requests to take the newborn tohis parent's room. Which of the following actions should the nurse take? Check the newborn's identication bracelet with the chart.Obtain permission from the newborn's mother. Respectfully deny the grandparent's request.Review the newborn's footprint record 16. A nurse enters a client's room and finds the client pulseless. The client's living will requests no resuscitation be performed, but the provider has not written the prescription.Which of the following actions should the nurse take? A client who has acute cholecystitis and reports abdominal pain radiating to the right shoulder A client who has had a total knee arthroplasty, is 1 day postoperative, and reports a pain level of8 on a 0 to 10 pain scale A client who has a fractured femur and reports sudden sharp chest pain 20. An occupational health nurse in a factory is planning interventions to reduce environmental stressors for employees. Which of the following interventions should thenurse use to aect physical agents in the environment? (Select all that apply.) Teach workers to choose personal strategies to cope with work stress. Limit the amount of time workers spend in temperatures over 43.3° C (110° F).Provide ear plugs for use at workstations throughout the factory. Obtain dosimeters for employees to wear when using new machinery that emits radiation.Require more frequent disinfection of work surfaces during inuenza season. 21. A nurse is using the ecologic model for population health to develop interventions to address HIV in a community. Which of the following interventions should the nurseinclude to address financial factors affecting community health? Have adolescents lead peer discussions in schools about safe sexual practices.Distribute condoms through remote community clinics. Create commercial advertisements describing the long-term eects of HIV. Include information about perinatal HIV transmission at prenatal education classes. 22. A nurse is planning a staff education program to review nursing interventions for clients who have kidney failure. Which of the following sources should the nurse identify as thebest resource for obtaining evidence-based information? The advice of an expert nephrology nurseRetrospective chart reviews Facility critical pathway A recent peer-reviewed nursing research article Administering an oral antibiotic to a client Performing an admission assessment of a client Creating new teaching for a guardian of a toddlerAdministering IV conscious sedation to a client 27. A nurse on a rehabilitation unit is creating a plan of care for a newly admitted client whohas difficulty swallowing following a stroke. Which of the following interprofessional team members should the nurse anticipate consulting regarding the client's condition?(Select all that apply.) ??? Speech-language pathologistOccupatio nal therapist Dietitian Psychologist Pharmac y technicia n 28. A forensic nurse is using the epidemiological triangle to explain factors that contribute toviolent behavior. Which of the following factors should the nurse identify as an environmental factor in the epidemiological triangle? Crowded living conditionsTraumatic brain injury Alzheimer's disease Impaired coping abilities 29. After signing an informed consent form, a client states, "I have changed my mind and donot want to have the procedure." Which of the following actions should the nurse take? Suggest that family members discuss the importance of the surgery with the client. Notify the surgeon that the client wishes to withdraw informed consent for the procedure.Document the risks of refusing the procedure in the client's medical record. Discuss the benets of the procedure with the client 31. A public health nurse is developing guidelines for management of a botulism outbreak.Which of the following information should the nurse include? High-risk individuals should receive immunoglobulin E (IgE). Implement airborne precautions for clients who have botulism. Administer an aminoglycoside medication. Rinse skin with soap and water following exposure to the botulism toxin. 32. A county public health nurse is developing a list of interventions to address the three corefunctions of public health. Which of the following interventions should the nurse includeas part of the assurance function? Use surveillance to investigate outbreaks of foodborne illness.Monitor the incidence rates of varicella every 2 months. Organize an immunization clinic for at-risk members of the community.Educate the community about the health risks of alcohol use. 33. A nurse is discussing organ donation with a newly licensed nurse. Which of the followingstatements should the nurse include in the teaching? (Select all that apply.) "To harvest a client's organs, they must provide consent prior to death.""The donor client's provider will harvest the organs for donation." "During admission, all clients over the age of 18 should be asked about their organ donor status.""The National Organ Transplant Act prohibits the sale and purchase of organs." "Documentation about the client's organ donor preference is placed in the electronic medical 34. A case manager at an assisted living facility is reviewing the use of complementary healthpractices by several clients. Which of the following actions should the case manager plan to take? Plan to report a client's use of echinacea to the provider as a contraindication to aspirin therapy. Plan to schedule time for a new client to continue tai chi practice as a stress reduction technique.Tell a client that yoga has not been proven eective to reduce manifestations of menopause. Tell a client who drinks cranberry juice daily that it can help treat existing urinary tractinfections. 35. A nurse manager is teaching a group of sta members about proper body mechanics. Which of the following statements by a sta member indicates an understanding of theteaching? "I should get assistance when lifting more than 35 pounds.""I will twist at my waist when moving an object." "I should hold objects 1 ft away from my body when I walk." "I will roll my shoulders forward to reduce strain on my back." 36. A nurse in a clinic is caring for a client who has a urinary tract infection (UTI). Which ofthe following prescriptions should the nurse verify with a provider? ??? Trimethoprim- sulfamethoxaz ole Hyoscyamine Oxybutynin Phenazopyridi ne 37. A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). The client states, "I am ready to go immediately." Which of the following actionsshould the nurse take first? Teach the client about the potential health risks of leaving early.Ask the client to sign a document stating they are leaving AMA. More frequent dental preventative care visits 39. A nurse at a local health department is caring for a client who is newly diagnosed withlisteriosis. Which of the following actions should the nurse plan to take? Provide the Centers for Disease Control (CDC) and Prevention with the client's information.Inform the client that they are required to have health department sta directly observe their treatment. Determine whether the condition is reportable under state requirements.Find out whether the condition is endemic in the client's neighborhood 40. A nurse working in a mobile health clinic is assessing a migrant farm worker. Which ofthe following findings should the nurse identify as the priority? Report of back pain associated with twisting at the waistAbsence of a dental health provider Lives in a home with 25 other migrant workersReport of muscle twitching and skin rash 41. A school nurse is developing a teaching plan about testicular cancer for a group of clients.Which of the following information should the nurse include in the teaching? Perform a testicular self-examination weekly. Do not palpate the epididymis when performing a testicular self-examination. Expect testicles to be uniform in consistency when performing a testicular self- examination.Perform a testicular self-examination after a cool shower. 42. A parent of a child who is terminally ill tells a nurse that she wants to take her childhome. Which of the following responses should the nurse make? "Your provider will be here later today." "I can give you information on what that would involve." "I understand how you feel. I felt the same way when my sister was terminally ill." "I think you should speak with social services about your request." 43. During an initial visit, a home health nurse is assessing a client who has cultural beliefsdifferent than their own. Which of the following questions should the nurse ask to determine the client's beliefs about environmental control? "Do you spend more time thinking about the past, present, or future?""Who makes most of the decisions in your family group?" "What do you think you can do to affect your health status?" "Can you list any diseases that your parents or siblings have had?" 44. A nurse is caring for a client who has an ethical conflict about the care she is receiving. Which of the following resources should the nurse consult about resolving the dilemma? Hospital ethics committee Quality improvement committeeChaplain Director of nursing 45. A charge nurse is planning care for a group of clients on a medical- surgical unit. Whichof the following tasks should the nurse delegate to an assistive personnel (AP)? Giving a glycerin suppository to a client for constipation Evaluating the effectiveness of ibuprofen administered to a client who reported a headacheDiscussing dietary changes with a client who has a prescription for a gluten-free diet Measuring hourly urinary output A client who is prescribed gastric lavage treatments to treat acute aspirin toxicity 47. A nurse manager on an acute care unit is preparing a staff presentation about promotingcost effective care. Which of the following strategies should the nurse plan to include inthe presentation? Change IV solution bags every 36 hr. Avoid the delegation of hygiene care to assistive personnel (AP).Wear sterile gloves when removing urinary retention catheters. Educate staff about the correct use of personal protective equipment (PPE) for isolation precautions. 48. A nurse is providing a report to an occupational therapist about a client who weighs 210lb and has a prescription for one-third weight bearing on the right leg to prevent injury and falls. How many kg of weight should the client bear on the right leg? (Round the answer to the nearest whole number. Use aleading zero if it applies. Do not use a trailingzero.) 49. 32kg kg 50. A nurse in an emergency department is preparing change-of-shift report for an adult clientwho is transferring to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the report? (Select all thatapply.) The client has a do-not-resuscitate order. The client has a continuous IV of lactated Ringer's. The client was straight catheterized for 350 mL 2 hr ago.The client has Medicare insurance. The client lives in a one-story home