Nursing and Healthcare Regulations: Ensuring Quality and Safety, Exams of Nursing

Download Nursing and Healthcare Regulations: Ensuring Quality and Safety and more Exams Nursing in PDF only on Docsity! N3632 Foundations Final Exam (250 Questions and Answers). 2024 EXAM SOLUTION BEST GRADED A+ __________ ensure that health care providers and agencies comply with state regulations. - SOLUTION State licensing boards __________ sets quality standards for accreditation of health care facilities. - SOLUTION The Joint Commission QSEN - SOLUTION Quality and Safety Education for Nurses - assists nursing programs in preparing nurses to provide safe, high-quality care. What are the six QSEN competencies? - SOLUTION Safety Patient-Centered Care Evidence Based Practice Informatics Quality Improvement Teamwork and Collaboration __________ is the right to make one's own personal decisions, even when those decisions might not be in that person's own best interest. - SOLUTION Autonomy __________ is the action that promotes good for others. - SOLUTION Beneficence __________ is the fulfillment of promises. - SOLUTION Fidelity __________ is fairness in care delivery and use of resources. - SOLUTION Justice __________ is a commitment to do no harm. - SOLUTION Nonmaleficence __________ is a commitment to tell the truth. - SOLUTION Veracity What are the 2 types of unintentional torts? - SOLUTION negligence and malpractice An example of __________ is when a nurse fails to implement safety measures for a client at risk for falls. - SOLUTION Negligence An example of __________ is when a nurse administers a large dose of medication due to a calculation error. The client has cardiac arrest and dies. - SOLUTION Malpractice What are the 2 types of quasi-intentional torts? - SOLUTION Breach of confidentiality and defamation of character An example of __________ is when a nurse releases a client's medical diagnosis to a member of the press. - SOLUTION Breach of confidentiality An example of __________ is when a nurse tells a coworker that they believe the client has been unfaithful to their partner. - SOLUTION Defamation of character What are the 3 types of intentional torts? - SOLUTION assault, battery, false imprisonment __________ is when the conduct of one person makes another person fearful and apprehensive. - SOLUTION Assault Ex: A nurse threatens to place an NG tube in a client who is refusing to eat. __________ is intentional and wrongful physical contact with a person that involves an injury or offensive contact. - SOLUTION Battery Ex: A nurse restrains a client and administers an injection against their wishes. __________ is when a person is confined or restrained against their will. - SOLUTION False imprisonment Ex: A nurse uses restraints on a competent client to prevent the leaving the health care facility. __________ are infections that a client acquires while receiving care in a health care setting. - SOLUTION Health-care associated infections (HAIs) An __________ is a type of HAI resulting from a diagnostic or therapeutic procedure. - SOLUTION Iatrogenic infection True or False: HAIs are always preventable and always iatrogenic. - SOLUTION False. What are some atypical findings that can indicate an infection in older adults? - SOLUTION agitation, confusion, or incontinence What findings are expected in the first stage of the inflammatory response? - SOLUTION redness, warmth, edema, pain or tenderness, loss of use of the affected part What findings are expected in the second stage of the inflammatory response? - SOLUTION Exudate (serous, sanguineous, and/or purulent) What findings are expected in the third stage of the inflammatory response? - SOLUTION Damaged tissue is replaced with scar tissue; gradually, the new cells take on characteristics that are similar in structure and function to the old cells __________ applies to all bodily fluids (except sweat), non-intact skin, and mucous membranes; should be implemented for all clients. - SOLUTION Standard precautions True or False: hand washing is the most effective in removing microorganisms. - SOLUTION False: Using alcohol-based products is more effective in removing microorganisms. Soap and water should be used instead of an alcohol-based product when a patient has __________ - SOLUTION C. difficile For which infections should a nurse use airborne precautions? - SOLUTION measles, varicella, and pulmonary or laryngeal tuberculosis __________ airflow exchange should be used for patients on airborne precautions. - SOLUTION Negative pressure Negative pressure airflow exchange in the room should have at least __________ exchanges per hour. - SOLUTION 6 to 12 For which infections should a nurse use droplet precautions? - SOLUTION pneumonia, Haemophilus influenzae type B, scarlet fever, rubella, pertussis, mumps, mycoplasma pneumonia, meningococcal pneumonia and sepsis, and the pneumonic plague For which infections should a nurse use contact precautions? - SOLUTION shigella, enteric diseases caused by microorganisms, wound infections, herpes simplex, impetigo, scabies, multidrug-resistant organisms A __________ is an intervention (not type of precaution) to protect clients who are immunocompromised. - SOLUTION Protective environment A protective environment requires __________ airflow. - SOLUTION positive In an emergency situation when there is immediate risk to the client or others, nurses can place restraints on a client. A prescription from the provider must be obtained ASAP, usually within __________ hour(s). - SOLUTION 1 hour The prescription allows only __________ hours of restraints for an adult. - SOLUTION 4 Providers can renew prescriptions for a restraint with a maximum of __________ hours. - SOLUTION 24 consecutive True or False: Providers can write PRN prescriptions for restraints. - SOLUTION False. How often should the nurse assess skin integrity and provide skin care to a patient in restraints? - SOLUTION every 2 hours True or False: The nurse should offer range-f-motion exercises of the extremities to patients in restraints. - SOLUTION True Fires in health care facilities are usually due to __________. - SOLUTION electrical or anesthetic equipment or from smoking RACE stands for __________. - SOLUTION rescue, alarm, contain, extinguish __________ are at risk for injury due to a tendency to put objects in their mouth and from hazards encountered while exploring their environment. - SOLUTION Infants and toddlers __________ often face injury from limited or underdeveloped motor coordinatino. - SOLUTION Preschool- and school-aged children __________ risks for injury can stem from increased desire to make independent decisions and relying on peers for guidance rather than family. - SOLUTION Adolescents' __________ continue to be a major cause of death and injury for people of all ages. - SOLUTION Home fires __________ is a major cause of illness in the United States. - SOLUTION Food poisoning __________ position prevents regurgitation of enteral feedings and aspiration by clients who have difficulty swallowing. It also promotes lung expansion for clients who have dyspnea or are receiving mechanical ventilation. - SOLUTION Semi-Fowlers: 15º - 45º, typically 30º __________ position is useful during procedures (nasogastric tube insertion and suctioning). It allows for better dependent drainage after abdominal surgeries. - SOLUTION Fowler's: 45º - 60º __________ position promotes lung expansion by lowering the diaphragm and thus helps relieve severe dyspnea. It also helps prevent aspiration during meals. - SOLUTION High Fowler's: 60º - 90º The client lies on their back with the head and shoulders elevated on a pillow and forearms on pillows at their sides. A foot support prevents foot drop and maintains proper alignment. - SOLUTION Dorsal recumbent Infants should sit in a rear-facing car seat at least until age __________. - SOLUTION 2 __________ is acute, temporary, and can have a physiological source or related to a change in surroundings. This is often the first manifestation of infection in older adults. - SOLUTION Delirium __________ is chronic, progressive, and possibly with an unknown cause. - SOLUTION Dementia __________ is chronic and can have an acute or gradual onset; This is often due to loss of a loved one, feelings of isolation, or chronic disease. - SOLUTION Depression When palpating, the __________ is most sensitive to temperature. - SOLUTION Dorsal surface When palpating, the __________ is sensitive to vibration. - SOLUTION Palmar surface True or False: The average body temperature for older adults is 95.9º to 99.5º F. - SOLUTION True __________ is the difference between the apical rate and the radial rate. - SOLUTION Pulse deficit Which age group can have a slightly elevated systolic pressure due to decreased elasticity of blood vessels? - SOLUTION Older adults Which ethnic group has a higher incidence of hypertension in general and at earlier ages? - SOLUTION African Americans The width if the blood pressure cuff should be __________ of the arm circumference at the point where the cuff is wrapped. - SOLUTION 40% The bladder if the blood pressure cuff should surround __________ of the arm circumference of an adult. - SOLUTION 80% When taking blood pressure, the cuff should be inflated __________ above the palpated systolic pressure. - SOLUTION 30 mmHg True or False: In therapeutic communication, silence allows time for meaningful reflection. - SOLUTION True __________ is when there are abusive words or actions of peers. - SOLUTION Lateral violence This includes gossiping, exclusion of information, threats of harm, and actual harm. Adjusting to a chronic disease or stressful job change would be classified as __________ stress. - SOLUTION Situational __________ stress varies with life stages. - SOLUTION Developmental Adult stressors can include losing parents, having a baby, and getting married. True or False: Substance abuse, lack of education, and prolonged poverty can cause stress. - SOLUTION True This is stress caused by sociocultural factors. True or False: The presence of stressors delays a client's return greater than the presence of a foreign body or infection delays the healing of a wound. - SOLUTION False: Stress delays the body's return to health in the same way that a foreign body or infection would. What are the three stages of the stress reaction? - SOLUTION Alarm stage, resistance stage, and exhaustion stage In this stage of stress, body functions are heightened to respond to stressors, also called fight-or-flight response. - SOLUTION Alarm stage In this stage of stress, body functions normalize while responding to the stressor. - SOLUTION Resistance stage In this stage of stress, the body functions are no longer able maintain a response to the stressor and the client cannot adapt. - SOLUTION Exhaustion stage True or False: The end of the exhaustion stage of stress results in recovery or death. - SOLUTION True This develops when a person must assume opposing roles with incompatible expectations. - SOLUTION Role conflict This develops when expectations of others and society regarding how one should behave when sick. - SOLUTION Sick role This occurs when there is uncertainty about what is expected when assuming a role; creates confusion. - SOLUTION Role ambiguity This frustration and anxiety develops when a person feels inadequate for assuming a role. Caregiver burden results from the accumulated stress of caring for someone else over time. - SOLUTION Role strain This develops when there is more responsibility and roles than are manageable; very common. - SOLUTION Role overload True or False: Sexuality affects health status. - SOLUTION True True or False: Ethnicity affects culture. - SOLUTION True When exposed to a new culture, individuals can undergo the process of __________ and adopt some of the cultural practices of the predominant group. - SOLUTION Acculturation __________ is the process where an individual adopts the predominant culture and form a new cultural identity. - SOLUTION Assimilation __________ involves self-awareness for the nurse, examining personal attitudes related to various aspects of culture, to identify possible bias. - SOLUTION Cultural awareness __________ means that nurses are knowledgeable about the cultures prevalent in their area of practice. - SOLUTION Cultural sensitivity True or False: Nurses may not contact the family after a client has passed. - SOLUTION False Nurses may go to a client's funeral, communicate in writing with to the family while maintaining professional boundaries. __________ is the most common sleep disorder. - SOLUTION Insomnia __________ is the inability to get an adequate amount of sleep and to feel rested. - SOLUTION Insomnia This can mean difficulty falling asleep, difficulty staying asleep, awakening too early, or not getting refreshing sleep. True or False: Young men are more prone to insomnia. - SOLUTION False Women and older adults are more prone to insomnia. __________ is a central nervous dysfunction in the respiratory control center of the brain that fails to trigger breathing during sleep. - SOLUTION Central sleep apnea __________ is when the structures in the mouth and throat relax during sleep and occlude the upper airway. - SOLUTION Obstructive sleep apnea __________ is excessive daytime sleepiness lasting at least 3 months. - SOLUTION Hypersomnolence disorder __________ provide most of the body's energy and fiber. - SOLUTION Carbohydrates Each gram of carbohydrate produces __________ kcal. - SOLUTION 4 __________ provide energy and vitamins. - SOLUTION Fats Each gram of fat produces __________ kcal. - SOLUTION 9 __________ contribute to the growth, maintenance, and repair of body tissues. - SOLUTION Protein Each gram of protein produces __________ kcal. - SOLUTION 4 A, D, E, and K are __________ -soluble vitamins - SOLUTION fat C and B complex vitamins are __________ -soluble. - SOLUTION Water Older adults require __________ calories. - SOLUTION Fewer True or False: Older adults need more vitamins and minerals than younger adults. - SOLUTION False Older adults need the same amount of most vitamins and minerals as younger adults. A BMI over 30 is considered __________ - SOLUTION Obese A BMI of 26 is considered __________. - SOLUTION Overweight 1 oz = __________ mL - SOLUTION 30 To prevent aspiration, the client should be placed in __________ position. - SOLUTION High-Fowler's True or False: Clients at risk of aspiration should tuck their chin when swallowing to help propel food down the esophagus. - SOLUTION True True or False: Clients at risk of aspiration should drink liquids through a straw. - SOLUTION False The use of a straw should be avoided in clients at risk for aspiration. Clients should be in semi-Fowler's for at least __________ hr(s) after meals. - SOLUTION 1 Clear liquids, gelatin, and broths are part of a __________ diet. - SOLUTION Clear liquid Clear liquids plus liquid dairy products, and all juices are a part of a __________ diet. - SOLUTION Full liquid Foods such as dairy products, eggs, and ripe bananas are a part of a __________ diet. - SOLUTION Soft/low residue These are foods that are low in fiber and easy to digest. Whole grains, raw and dried fruits are part of a __________ diet. - SOLUTION High-fiber A low sodium diet should have a maximum of __________ of sodium per day. - SOLUTION 2 g A low cholesterol diet should have no more than __________ of dietary cholesterol per day. - SOLUTION 300 mg A diabetic diet is limited to about __________ calories per day. - SOLUTION 1,800 A client with dysphagia will likely be prescribed a diet comprising of __________. - SOLUTION Pureed foods and thickened liquids Skin assessments should be conducted every __________ hour(s). - SOLUTION 2 Clients should consume at least __________ mL fluid per day, unless intake is restricted. - SOLUTION 2,000 Nurses should encourage active or provide passive ROM exercises __________ times per day. - SOLUTION 2 or 3 When using a cane, a client should maintain __________ points of support on the ground at all times. - SOLUTION 2 A cane should be placed on the __________ side of the body. - SOLUTION Stronger When using crutches, the body weight should be supported at the hand grips with elbows flexed at __________. - SOLUTION 20º to 30º True or False: Older adults are at an increased risk for undertreatment of pain. - SOLUTION True Older adults are at an increased risk for undertreatment of pain, as well as increased risk for adverse events following analgesia administration. Therapeutic touch involves __________. - SOLUTION Using hands to help bring energy fields into balance Aloe is used for __________. - SOLUTION Wound healing Chamomile is used for __________. - SOLUTION Anti-inflammatory, calming Echinacea is used to __________. - SOLUTION Enhance immunity Garlic is used to __________. - SOLUTION Inhibit platelet aggregation Ginger is used as an __________. - SOLUTION Antiemetic Ginkgo biloba is used to __________. - SOLUTION Improve memory Ginseng is used to __________. - SOLUTION Increase physical endurance Valerian is used to __________. - SOLUTION Promote sleep, reduce anxiety Clients should receive __________ g of fiber per day. - SOLUTION 25 to 38 Foods that increase gas are __________. - SOLUTION Cabbage, cauliflower, apples Foods that have a laxative effect include __________. - SOLUTION Figs and chocolate Foods that increase the risk for constipation include __________. - SOLUTION Pasta, cheese, and eggs Chronic use of laxatives causes a weakening of the bowel's expected response to distention from feces, resulting in the development of chronic __________. - SOLUTION Constipation True or False: Frequent use of laxatives can cause constipation. - SOLUTION True True or False: Antibiotic therapy may cause constipation. - SOLUTION False. Antibiotic therapy may cause diarrhea. When performing a digital rectal exam, caution should be taken to not stimulate the vagus nerve, which can result in __________. - SOLUTION Bradycardia Which foods can cause a false positive result in a fecal occult blood test? - SOLUTION Red meats, citrus fruit, and raw vegetables When performing a cleansing enema, the rectal tube should be inserted __________ inches. - SOLUTION 3 to 4 When performing a cleansing enema, the bag should be placed __________ above the anus. - SOLUTION 12 to 18 inches When performing an enema, the nurse should __________ if the client reports cramping or if fluid leaks around the tube at the anus. - SOLUTION Slow the flow of the solution by lowering the container When inspecting the stoma of an ostomy, it should appear __________. - SOLUTION moist, shiny, and pink True or False: A client may go into metabolic acidosis as a result of diarrhea. - SOLUTION True Metabolic acidosis may occur as a result of excess loss of bicarbonate. Signs of hypernatremia include __________. - SOLUTION muscle weakness, lethargy, swollen red tongue Signs of hypokalemia include __________. - SOLUTION leg cramps, muscle weakness, nausea, vomiting, and cardiac dyshythmias Most adults produce __________ urine per day. - SOLUTION 2,000 mL An increase in __________ leads to decreased urination. - SOLUTION Sodium Which 2 classes of medication cause urinary retention? - SOLUTION Antihistamines and anticholinergics True or False: Diuretics prevent the reabsorption of water. - SOLUTION True Amitryptaline turns urine __________. - SOLUTION Green-blue Phenazopyridine turns urine __________. - SOLUTION Orange, red Levodopa turns urine __________. - SOLUTION Dark (brown) Riboflavin turns urine __________. - SOLUTION Bright yellow Less than __________ mL/hr of urine for more than 2 hr is a cause for concern. - SOLUTION 30