Nursing Care and Healthcare Technology: Priorities and Considerations, Exams of Nursing

Download Nursing Care and Healthcare Technology: Priorities and Considerations and more Exams Nursing in PDF only on Docsity! NUR 213 MODULE 46 HEALTHCARE SYSTEMS QUESTIONS WITH ANSWERS 2024 UPDATE 1) The nurse is caring for a client who sustained multiple injuries in an automobile accident. As a part of secondary prevention for this client, which does the nurse include in the plan of care? A) Promote wellness. B) Detect early disease. C) Restore the client to previous functioning. D) Prevent the progression of more symptoms. 2) A nurse educator is teaching a group of students about managed care. The educator knows that the students have understood the concept when they state that managed care has which emphasis? Select all that apply. A) Bringing services of multiple providers to the client B) Organizing healthcare services around the stated needs of the client C) Cost-effective care D) Preventive services E) Health promotion 3) A nurse working on a medical-surgical unit has opted to return to school to earn a Bachelor of Science in Nursing (BSN) degree. After considering projected changes in healthcare and the population cared for in the community, which includes an expanding minority population composed largely of immigrants arriving from Central and South America as well as older adults as the fastest-growing demographic, the student might consider selecting which elective course? A) A course on medical Spanish B) A psychology course on young adults C) A personal finance class D) A class on the effect of illness on a young child 4) The manager of a small clinic has cross-trained the nurses to perform electrocardiogram (ECG) testing, phlebotomy, and some respiratory therapy interventions. This clinic is providing client-focused care. Which of the following actions shows this delivery model in action? A) Many disciplines collaborate to provide client care. B) Client care is carefully managed to control costs. C) If a client complains of breathing difficulty, nurses concentrate on respiratory therapy for that client. D) Client progress is efficiently tracked. 5) A nurse is planning a community health fair at a local community center. Which goals regarding health promotion does the nurse plan to highlight at the event? Select all that apply. A) The ability to change and modify goals as health needs change B) The ability for clients to be able to assess and evaluate their health needs C) The ability for the client to promote health in other individuals D) The ability to promote cost-saving techniques to healthcare providers E) The ability to prevent disease by imitating nursing techniques 6) The nurse knows that communication among healthcare team members is essential during mass casualty events (MCEs). Which is essential when communicating under these circumstances? A) Providing concise, accurate, and timely information B) Preparing for ethical challenges C) Documenting to prevent legal issues D) Coordinating care between management and clinicians 7) Why should job seekers in the healthcare sector pay attention to advances in healthcare technology? A) Advances in technology require specialized personnel. B) Advances in technology involve policies and strategies at the organizational level. C) Changing demographics increase the need for new jobs. D) Technology plays a role in health literacy. 8) The nurse is taking care of a client who is being discharged but will need home nursing care, physical therapy, and speech therapy. Which framework helps the client who has multiple care needs? A) Case management B) Client-focused care C) Managed care D) A health maintenance organization 9) If more older adults live in Mississippi than elsewhere in the United States and clients in Massachusetts have much greater access to health services than clients elsewhere in the United States, then what does this imply about access of older adults to healthcare in Mississippi? A) The likelihood is that more specialists serving older populations will work in Mississippi than in Massachusetts. B) Their access to healthcare should be roughly equal to that of older adults living in Massachusetts but with a different mix of providers. C) The need for services will be much greater for older adults in Mississippi than in Massachusetts due to a decreasing number of healthcare providers. D) There will be much more robust rural services for older adults in Mississippi than in Massachusetts. 10) The nurse educator is presenting information to a group of nursing students regarding uninsured and underinsured clients. Which of the following is the best example of this problem for the educator to share with the students? A) "Delays of diagnoses lead to higher mortality and morbidity rates." B) "Delays in health coverage for children put the health provider at risk for litigation." C) "Immunizations are free for children at public health clinics." D) "Older adults are less likely to be treated for falls." D) To advocate for resources through different business sources Exemplar 46.A Emergency Preparedness 1) The nurse is participating on a local council as an advisor regarding community needs during an emergency. Which recommendation regarding community needs during an emergency that the nurse might include when advising the council would be involved in the emergency response phase? A) A coordinated emergency preparedness plan B) Assembling disaster kits C) Programs to restore the community D) The identification of potential hazards to the community 2) A hospital in the community has been notified of a multi-car crash on the interstate that will result in the transfer of many injured clients to the hospital. As part of the emergency response, the charge nurses in the emergency department (ED) and intensive care unit (ICU) are responsible for which tasks? Select all that apply. A) Assigning care for the clients as they are admitted to the unit B) Exceeding their scope of practice when and if required C) Assessing the priority of the current clients for the ED or ICU D) Delegating staff nurses to gather needed supplies for the arriving clients E) Providing any care that any patient needs 3) The charge nurse assesses clients during a mass casualty incident (MCI) and transfers some to other units but discharges others to home. In planning for the admission of critically ill clients from the emergency department, to which nurses will the charge nurse assign the new clients when admitted to the unit? A) Nurses with risk-reduction knowledge B) Nurses with advanced assessment skills C) Nurses with impeccable ethics D) Nurses with exceptional self-care methods 4) A group of nurses attend an in-service regarding emergency preparedness for the hospital. One of the nurses has three small children and lives in a two-story house in the suburbs. After the class, the nurse plans to initiate which action to enhance family safety? A) Training her family in performing nursing interventions to take part in an emergency response B) Obtaining a fire escape ladder for the second floor of the home C) Developing a plan for her family to join her in the event of an emergency D) Ensuring she and her family move to a safe area unlikely to be involved in a disaster 5) A nurse recently attended a seminar that discussed the many threats to homeland security. As nurse manager of the emergency department, the nurse is responsible for planning for emergencies from bioterrorism. Which agents does the nurse include when planning for bioterrorism? Select all that apply. A) Anthrax B) Tuberculosis C) Cancer D) Flu E) Smallpox 6) A nurse is performing START triage for clients injured in a terrorist attack. Which client would the nurse classify as expectant? A) Client is breathing but has an absent radial pulse. B) Client has a respiratory rate below 30. C) Client is apneic after positioning of an airway. D) Client is breathing adequately with a radial pulse but does not obey commands. 7) The nurse is working with an emergency response team following massive flooding caused by a hurricane. What will working with the Clinical Outreach Communication Activity (COCA) team enable the nurse to do? A) Have two-way communication with the Centers for Disease Control and Prevention (CDC) concerning infection risks. B) Facilitate communication between doctors in the field during a disaster and their healthcare team. C) Provide resources to the community during times of disaster. D) Provide expert advice to other nurses during natural disasters. 8) The nurse manager is discussing the preparedness phase of a revised emergency management plan for the emergency department. The American Nurses Association (ANA) is a resource the nurse manager can use to help nurses understand which of the following during an emergency response? A) The ethics of emergency response B) The procedure for working in a hot zone during a hazardous material incident C) The role of the incident commander in a disaster response D) The best means of communicating with agencies such as the Centers for Disease Control and Prevention (CDC) during a crisis 9) A nurse is responding in the aftermath of a hurricane. Hundreds of clients demand attention. The nurse will implement which of the following in assessing the priority of these clients? A) Reverse triage B) Standard emergency department triage C) A disaster response plan D) American Nurses Association (ANA) ethics rules 10) A railway accident causes the release of a dangerous chemical compound into the atmosphere. The nurse providing rapid triage and emergency treatment for clients in an effort to stabilize them knows that which is the primary purpose of the warm zone in this incident? A) Decontamination B) Rapid triage C) Reverse triage D) Emergency medical treatment 11) Terrorists have detonated a bomb in the downtown area of a major city, destroying part of a hotel, damaging nearby buildings, and killing or injuring an unknown number of people. A nurse in an emergency department handling many clients injured in the explosion receives a phone call from the babysitter for her children aged 5, 6, and 9, who says she's been watching the event unfold on TV since it happened. The nurse's family lives in a suburb more than 20 miles from the downtown. What should the nurse say? A) "Explain to the children that the people who did this are sick and will be punished for what they've done." B) "Please continue to watch the TV coverage with my kids in the room to ensure that you know what's going on at all times." C) "Please tell my children I'm alright but turn off the television and play a game with them to get them thinking about something else." D) "If you plan to continue to watch the TV coverage, please do it on the TV in my bedroom away from the kids." 12) The detonation of several incendiary devices in a suburban area has caused widespread fires. A nursing home nearest one of the largest fires needs to be evacuated. What is the concern a nurse working in the home will have for his clients in this situation? A) Socioeconomic limitations B) Diminished sensory awareness C) Inadequate thermoregulation mechanisms D) Limited mobility Exemplar 13.G Spinal Cord Injury 1) An adolescent is brought into the emergency department (ED) with injuries sustained from a motor vehicle crash. What is a priority while providing nursing care for this client? A) Adequate urine output B) Stable blood pressure C) Continued stabilization of the neck and spinal cord D) Insertion of an intravenous access line 2) A school nurse is treating a school-age client who has fallen down a flight of stairs. The client is breathing but unconscious. After calling the ambulance, which is the priority action by the nurse? A) Open the airway using the head tilt maneuver. B) Try to rouse the client by gently shaking the shoulders. C) Protect the client's neck and head from any movement. D) Place the client on the side to prevent aspiration. 3) A client who sustained a cervical neck injury 2 days ago is demonstrating an irregular respiratory pattern with a rate of 8-10 breaths per minute. Based on this data, which is the priority nursing diagnosis? A) Impaired Physical Mobility B) Autonomic Dysreflexia C) Ineffective Breathing Pattern D) Impaired Gas Exchange 4) The nurse is planning care for a client admitted with a high thoracic spinal cord injury. Which interventions would be appropriate for the nursing diagnosis of Ineffective Peripheral Tissue Perfusion? Select all that apply. A) Discuss future care needs when the client is discharged. B) Increase fluids to 3000 mL per day. C) Turn and reposition the client every 2 hours. D) Assess for a full bladder. E) Assess blood pressure every 2-3 minutes. 1) The nurse prepares to obtain a urine sample from a client's closed drainage system. Place the procedure steps in the correct order. F) Clamp the drainage tubing at least 8 cm (3 in.) below the sampling port for 30 minutes. A) Disinfect the needle insertion site. B) Insert the needle at a 30-to 40-degree angle. E) Withdraw the required amount of urine. C) Unclamp the catheter. D) Transfer the urine to the specimen container. 2) The nurse prepares to obtain a urine specimen from a client's indwelling catheter. What is the nurse's understanding of the purpose of clamping the indwelling catheter prior to collection of urine? A) Decreases client discomfort. B) Increases urine production. C) Promotes sterile collection. D) Eases technique of procedure. 3) A nurse prepares to administer a warm water enema to a client. Place the steps of the procedure in correct order. F) Allow the solution to run through the tubing to remove air. E) Assist the client to the left lateral position with right leg flexed. D) Lift the upper buttock, insert the tube slowly. A) Raise the solution container. B) Open the clamp. C) Encourage the client to retain the solution. 4) The registered nurse acts as preceptor to a novice nurse who is placing an indwelling urinary catheter for a client. Which action by the novice nurse requires intervention by the preceptor? A) Removing and discarding clean gloves after opening the drainage package. B) Cleansing the urethral meatus before removing the catheter from the protective sleeve. C) Donning sterile gloves prior to attaching the catheter to the drainage system. D) Lubricating the tip of the catheter before inserting the tip of the prefilled syringe into the catheter side arm. 5) When placing the client on a bedpan, which position will the nurse place the client? A) High-Fowler's B) Semi-Fowler's C) Upright D) Supine 6) A nurse attempts to obtain a urine sample from a client's ileal conduit. After correct sterile catheterization, no urine output is noted. How should the nurse respond? A) Contact the health care provider. B) Reinsert the catheter. C) Ask the client to drink water. D) Advance the catheter further in the stoma. 7) When auscultating a client's AV fistula, the nurse notes a whooshing sound. What term is used to describe this finding? A) Bruit B) Murmur C) Gallop D) Click 8) An uncircumcised male client needs to provide a clean-catch urine sample. Which client teaching will the nurse provide the client regarding the procedure? Select all that apply. A) Retract the foreskin slightly. B) Pull the foreskin over the meatus. C) Use a circular motion to clean the meatus. D) Use each towelette only once, then discard. E) Void a small amount prior to collecting the sample. 9) When assessing the client's AV fistula, the nurse notes vibration at the fistula site. How should the nurse respond to this finding? A) Contact the health care provider. B) Ask the client how long this has occurred. C) Determine when the fistula was placed. D) Document the finding. 10) A nurse performs a sterile urine specimen collection from an ileal conduit. Which action by the nurse is incorrect and may lead to inaccurate results? A) Removing the collection pouch prior to obtaining the sample. B) Inserting the tip of the catheter into the stoma approximately 4 cm (1.5 inches). C) Obtaining the sample from the collection pouch. D) Placing towels around the stoma. 11) The home care nurse prepares to drain the fluid of a client with continuous ambulatory peritoneal dialysis (CAPD). Place the steps in correct order of the procedure to drain the fluid. E) Don gloves and uncap the catheter. A) Attach the sterile bag and transfer set to the catheter. B) Place the bag on a low stool or table below the client's abdomen. C) Unclamp the tubing and allow fluid to drain. D) Reclamp the tubing. 12) The nurse prepares to remove a client's indwelling urinary catheter. Which technique will the nurse use when performing this procedure? Select all that apply. A) Aspirate the balloon vigorously. B) Withdraw all the fluid from the balloon. C) Detach the catheter from the client's skin. D) Use clean gloves instead of sterile gloves. E) Place a towel between the client's legs. 13) The nurse prepares to perform an indwelling urinary catheterization for a client who will undergo surgery. Place the steps of client positioning and sterile glove donning in the correct order. B) Position the client. A) Open the drainage package, maintaining sterility. C) Remove and discard gloves; perform hand hygiene. D) Open the catheterization kit; apply sterile gloves. 14) The nurse cares for a client who requires hemodialysis and has an arteriovenous fistula. Which statements will the nurse include when teaching the client safety precautions for the AV fistula? Select all that apply. A) "Keep the AV fistula dry and avoid washing with soap." B) "Do not wear constrictive clothing or jewelry." C) "Avoid lifting heaving objects with the extremity that has the AV fistula." D) "Avoid lying on the extremity with the AV fistula." E) "Immediately report swelling or discoloration." 15) The home care nurse cares for a client who requires continuous ambulatory peritoneal dialysis (CAPD) at home. Place the steps in correct order for infusing the dialysate. A) Warm the dialysate. D) Perform hand hygiene and don gloves. B) Add medications to the dialysate as ordered. C) Connect tubing to dialysate bag. E) Hang the dialysate bag above the client's shoulder and open the clamp. 16) The nurse is planning care for a client who receives peritoneal dialysis. Which nursing diagnosis will the nurse determine is PRIORITY? A) Knowledge deficit B) Risk for infection C) Impaired skin integrity D) Fluid volume excess 17) The nurse cares for a client with an AV fistula for hemodialysis. Which assessments will the nurse perform when assessing the AV fistula? Select all that apply. A) Palpation B) Auscultation C) Inspection D) Percussion 18) The nurse teaches a client with a peritoneal dialysis catheter about the signs and symptoms of peritonitis. Which teaching statements will the nurse include? Select all that apply. A) "Monitor your temperature and report any fever." B) "Monitor your urine output and report any decrease in output." C) "Report any nausea or vomiting you may have." D) "Monitor the insertion site and report any redness." E) "Report any abdominal pain you may have." A. Prevention of further damage. B. Prevention of contractures of the lower extremities. C. Prevention of skin breakdown of areas that lack sensation. D. Prevention of postural hypotension when placing the client in a wheelchair. 2. A nurse is caring for a client who has a spinal cord injury who reports a severe headache and is sweating profusely. Vital signs include blood pressure 220/110 mm Hg and apical HR 54/min. Which of the following actions should the nurse take first? A. Notify the provider. B. Sit the client upright in bed. C. Check the urinary catheter for blockage. D. Administer antihypertensive medication. 3. A nurse is caring for a client who has a C4 spinal cord injury. The nurse should recognize the client is at greatest risk for which of the following complications? A. Neurogenic shock. B. Paralytic ileus. C. Stress ulcer. D. Respiratory compromise. 4. A nurse is caring for a client who experienced a cervical spine injury 24 hr ago. Which of the following types of prescribed medications should the nurse clarify with the provider? A. Glucocorticoids. B. Plasma expanders. C. H2 antagonists. D. Muscle relaxants. 5. A nurse is caring for a client who experienced a cervical spine injury 3 months ago. The nurse should plan to implement which of the following types of bladder management methods? A. Condom catheter. B. Intermittent urinary catheterization. C. Crede’s method. D. Indwelling urinary catheter. Blood and Blood Product Transfusions 1. A nurse is preparing to administer packed RBC’s to a client who has a Hgb of 8 g/dL. Which of the following actions should the nurse plan to take during the first 15 min of the transfusion? A. Obtain consent from the client for the transfusion. B. Assess for an acute hemolytic reaction. C. Explain the transfusion procedure to the client. D. Obtain blood culture specimens to send to the lab. 2. A nurse is caring for a client who is receiving a blood transfusion. Which of the following actions should the nurse expect if an allergic transfusion reaction is suspected? (Select all that apply) A. Stop the transfusion. B. Monitor for hypertension. C. Maintain an IV infusion with 0.9% sodium chloride. D. Position the client in an upright position with the feet lower than the heart. E. Administer Diphenhydramine. 3. A nurse is monitoring a client who began receiving a unit of packed RBCs 10 min ago. Which of the following findings should the nurse identify as an indication of a febrile transfusion reaction? A. Temperature change from 98.6 pretransfusion to 99.0. B. Current blood pressure 178/90. C. Heart rate change from 88/min pretransfusion to 120/min. D. Client report of itching E. Client appears flushed. 4. A nurse is providing preoperative teaching for a client who requests autologous donation in preparation for a scheduled orthopedic surgical procedure. Which of the following statements should the nurse include in the teaching? A. “You should make an appointment to donate blood 8 weeks prior to the surgery.” B. “If you need an autologous transfusion, the blood your brother donates can be used.” C. “You can donate blood each week if your hemoglobin is stable.” D. “Any unused blood that is donated can be used for other clients.” 5. A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure? A. Inserts an 18-gauge IV catheter in the client. B. Verifies blood compatibility and expiration date of the blood with an AP. C. Administers dextrose 5% in 0.9% sodium chloride IV with the transfusion. D. Obtains vital signs every 15 mins throughout the procedure. Diabetic Ketoacidosis 1. A nurse is reviewing the health record of a client who has hyperglycemic- hyperosmolar state (HHS). The nurse should identify that which of the following date confirm this diagnosis? (Select all that apply) A. Evidence of recent myocardial infarction. B. BUN 35 mg/dL. C. Takes a calcium channel blocker. D. Age 77 years. E. No insulin production. 2. A nurse is assessing a client who has diabetic ketoacidosis and ketones in the urine. The nurse should expect which of the following findings? (select all that apply) A. Weight gain. B. Fruity odor of breath. C. Abdominal pain. D. Kussmaul respirations. E. Metabolic acidosis. 3. A nurse is reviewing laboratory reports of a client who has HHS. The nurse should expect which of the following findings? A. Serum pH 7.2 B. Serum osmolarity 350 mOsm/L C. Serum potassium 3.8 mg/dL D. Serum creatinine 0.8 mg/dL 4. A nurse is preparing to administer IV fluids to a client who has diabetic ketoacidosis. Which of the following actions should the nurse take? A. Administer an IV infusion of regular insulin at 0.3 unit/kg/hr. B. Administer an IV infusion of 0.45% sodium chloride. C. Rapidly administer an IV infusion of 0.9% sodium chloride. D. Add glucose to the IV infusion when serum glucose is 350 mg/dL. 5. A nurse is providing discharge teaching to a client who has experienced diabetic ketoacidosis. Which of the following information should the nurse include in the teaching? (Select all that apply) A. Drink 2L of fluids daily. B. Monitor blood glucose every 4 hr when ill. 2. If you need an autologous transfusion, the blood your brother donates can be use 3. You can donate blood each week if your hemoglobin is stable 4. Any unused blood that is donated can be used for other clients A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure? 1. Inserts an 18 gauge IV catheter in the client 2. Verifies blood compatibility and expiration date of the blood with an assistive personnel 3. Administers dextrose 5% in 0.9% sodium chloride IV with the transfusion 4. Obtained vital signs every 15 minutes throughout the procedure Sterile technique When entering a clients room to change a surgical dressing, a nurse notes that the client is coughing and sneezing. Which of the following actions should the nurse take when preparing the sterile field? 1. Keep the sterile field at least 6 foot away from the clients bedside 2. instruct the client to refrain from coughing and sneezing during the dressing change 3. place a mask on the client to limit the spread of microorganisms into the surgical wound 4. keep a box of facial tissues nearby for the client to use during the dressing change a nurse has removed a sterile pack from its outside cover and placed it on a clean work surface in preparation for an invasive procedure. Which of the following flap should the nurse unfold first? 1. The flat closest to the body 2. the right side flap 3. the left side flap 4. the flat farthest from the body a nurse is wearing sterile gloves in preparation for performing a sterile procedure. Which of the following objects can the nurse touch without breaching sterile technique? Select all that apply 1. a bottle containing a sterile solution 2. the edge of the sterile drape at the base of the field 3. the inner wrapping of an item on the sterile field 4. An irrigation syringe on the sterile field 5. one gloved hand with the other gloved hand a nurse is reviewing hand hygiene techniques with a group of assistive personnel. Which of the following instructions should the nurse include when discussing handwashing? Select all that apply 1. apply 3 to 5 milliliters of liquid soap to dry hands 2. wash their hands with soap and water for at least 15 seconds 3. rinse the hands with hot water 4. use a clean paper towel to turn off the hand faucet 5. allow the hands to air dry after washing a nurse has prepared a sterile field for assisting a provider with a chest tube insertion. Which of the following events with the nurse recognize as contaminating the sterile field? Select all that apply 1. the provider drops a sterile instrument onto the near side of the sterile field 2. the nurse moistens a cotton ball with sterile normal Saline and places it on the sterile field 3. the procedure is delayed one hour because the provider receives an emergency call 4. the nurse turns to speak to someone who enters through the door behind the nurse 5. the clients hand brushes against the outer edge of the sterile field Disaster A newly hired public health nurse is familiarizing herself with the levels of disaster management. Which of the following actions is a component of disaster prevention? 1. Outlining specific roles of community agencies 2. identifying community vulnerabilities 3. prioritizing care of individuals 4. providing stress counseling