NURSING 108 FINAL EXAM QUESTIONS WITH ANSWERS, Exams of Nursing

Download NURSING 108 FINAL EXAM QUESTIONS WITH ANSWERS and more Exams Nursing in PDF only on Docsity! NURSING 108 FINAL EXAM QUESTIONS WITH ANSWERS 1. The RN is caring for an older adult patient admitted with frequent falls at home. Which initial strategy is most effective to improve patient outcomes? a. Coordination of care with an interdisciplinary team. b. Maintain bedrest with close supervision. c. Prepare for transfer to skilled nursing facility. d. Frequent hospitalizations help to manage illness effectively. 1.25 points Question 2 1. Which of the following collaboratives has the mission to work with federal and state agencies to strengthen policies and practices with the outcome of making people healthier? a. Quality and Safety Education for Nurses b. Healthy People 2020 c. The Institute of Medicine d. American Association of Retired People 1.25 points Question 3 1. What is a fundamental component in Dorothy Johnson’s model of nursing? a. The role of adaptation in nursing care provided to the patient. b. The interpersonal aspect of nursing, the relationship between patients and nurses. c. The relationship between cultural factors and nursing practice. d. The behavior of the client is key to preventing illness and restoring health. 1.25 points Question 4 1. What is a benefit of the Affordable Care Act? a. Eliminates co-pays for preventative services. b. Increases administrative costs for insurance companies. c. Decreases Medicaid payments to primary care physicians. d. Financially rewards technology driven acute hospital based services. 1.25 points Question 5 1. A patient is preparing to sign an informed consent document to participate in nursing research. Which statement by the patient indicates additional teaching is necessary? b. Competent care is a patient’s right and a provider’s obligation. c. If a health care provider agrees to care for a patient, there is an obligation to follow through. d. Patients should be treated equally regardless of socioeconomic status. 1.25 points Question 10 1. The RN sees a coworker enter a patient’s room without wearing the necessary personal protective equipment (PPE) for transmission-based precautions.Which is the best response by the RN? a. “Not wearing the correct PPE is bad nursing practice.” b. “Appropriate PPE is essential to reduce the risk of health care infections.” c. “Your behavior is why we have so many infections on this nursing unit.” d. “I wear all the PPE if I am not touching the patient.” 1.25 points Question 11 1. Why are all health care workers who interact with the patient expected to participate in a patient centered team meeting? a. To provide the leader an opportunity to display expertise. b. To instruct the team about the pre-determined decisions. c. To promote personal relationships with the team. d. To seek each member’s contribution to the plan of care. 1.25 points Question 12 1. The hospital is planning to implement a new bar code system for medication administration. Which statement describes the role of the RN to decrease medical errors? a. “I will ask to participate on the committee for bar code system design.” b. “A bar code system will eliminate the need for the RN to review medications.” c. “Training sessions should be optional for experienced nurses.” d. “I will learn to bypass the system during patient care emergencies.” 1.25 points Question 13 1. Which action by a health care worker demonstrates a potential violation of patient privacy information when using a computerized medical record? a. Posting a personal computer password in the nursing station. b. Using a privacy filter on computers that can be seen by others. c. Logging out of the computer screen when finished with documentation. d. Using institutional communication devices for work related issues. 1.25 points Question 14 1. The student nurse asks the RN the purpose of the patient satisfaction instrument called Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS). Which is the best response by the RN? a. Reward the physicians with the lowest mortality rates. b. Establish preventative services. c. Identify staff who need remediation. d. Measure quality of care. 1.25 points Question 15 1. The RN is assembling a health care team to help coordinate care for a homeless adult who has a leg ulcer. Which team member must the RN include? a. Occupational therapist b. Physical therapist c. Social worker d. “The internet is what I use to check hospital ratings.” 1.25 points Question 20 1. Which statement by the RN reflects an aggressive approach to conflict resolution? a. “It is not what I want, it is what the patient needs.” b. “I want to understand your position but it is still not clear to me.” c. “You need to follow my instructions exactly as I explained to you.” d. “We need to find a solution to this problem so that patient care doesn’t suffer.” 1.25 points Question 21 1. Which is an example of assertive communication by the RN during the interdisciplinary team patient care meeting? a. “The patient fell because he did not ask for help.” b. “We are here to seek ways to improve care.” c. “The intervention you are suggesting is wrong for this patient.” d. “The pharmacist needs to be reprimanded for delivering the meds late.” 1.25 points Question 22 1. The RN is meeting with a staff member to discuss recurrent late arrival for scheduled shifts. The staff member is highly animated and begins to explain multiple reasons for lateness. Which is the RN’s best response? a. “This behavior will not avoid the conversation. You need to be quiet and listen.” b. “You seem very upset. If you are on time in the future we can forget about this.” c. “You are lucky I am talking to you. Recurring lateness is grounds for dismissal.” d. “Please sit down and take a deep breath. We need to resolve this issue.” 1.25 points Question 23 1. The nurse manager solicits support from the nursing staff when preparing the unit budget. Which activities by the nursing staff assist with positive management of resources? Select all that apply. a. Promote self-care activities for all team members. b. Keep extra supplies in the patient’s room to save time. c. Delegate tasks to the appropriate health care worker. d. Prevent interruptions when administering medications. e. Use “down time” to have social conversations with peers. 1.25 points Question 24 1. The RN assisting with a sterile dressing change sees a colleague contaminate sterile gloves. What action should the RN take? a. Quietly tell the colleague that another break in sterile technique will be reported. b. State the problem immediately and provide another pair of sterile gloves. c. Say nothing because the patient is receiving antibiotics. d. Ask the nurse manager to provide education about sterile technique for the unit. 1.25 points Question 25 1. An RN worked with a team of individuals to design a discharge process for patients, resulting in an improved discharge system. This is an example of which approach to problem-solving? a. Rapid response process b. Root cause analysis c. Leapfrog process d. Lean six sigma d. Authoritarian 1.25 points Question 30 1. What information does the RN include when explaining to a nursing student the advantages of being employed at a magnet hospital? a. The preferred leadership style in a magnet hospital is authoritative. b. Magnet hospitals have better benefit packages than non-magnet hospitals. c. Non-magnet hospitals always have low patient satisfaction scores. d. Magnet hospitals undergo an external review to document standards of nursing excellence. 1.25 points Question 31 1. Which statement by the RN demonstrates an understanding of the benefit of The Joint Commission accreditation? a. “Accreditation certifies increased staffing levels on the nursing units.” b. “Accreditation signifies the organization will be the best choice for clients to receive care.” c. “Accreditation validates efforts on quality improvement for client outcomes.” d. "Accreditation provides a competitive edge in the healthcare marketplace.” 1.25 points Question 32 1. A student nurse asks the RN about the legal authority to delegate tasks. Which statement describes why RNs have the legal right to delegate? a. American Nurses’ Association Standards of Practice allow legal delegation by the RN. b. Employment by an institution approved for operation by the state provides legal authority to delegate. c. RNs are licensed and governed by a statutory practice act which allows legal delegation. d. Completion of a specialized program of professional study allows the RN to legally delegate. 1.25 points Question 33 1. An RN on the quality improvement (QI) team at a healthcare institution recognizes which data is associated with The Joint Commission National Patient Safety Goals (NPSGs)? a. “One NPSG focuses on the number of health provider consultations.” b. “Patient satisfaction is one of the NPSGs.” c. “NPSGs include recommendations for unit staffing ratios.” d. “Types of medication errors are included in the NPSGs.” 1.25 points Question 34 1. A student nurse tells the RN “My patient’s blood pressure is 120/80, and blood pressure medications were administered one (1) hour ago.” This is an example of which component of informatics? a. Data b. Skill c. Information d. Knowledge 1.25 points Question 35 1. Which task can the RN delegate to an unlicensed assistive personnel (UAP)? a. Measuring oral intake and output for a geriatric patient. b. Obtaining a blood pressure on a patient experiencing dizziness. c. Showing a patient how to empty a wound drainage device. 1.25 points Question 40 1. A nurse manager is fostering assertive behavior in the nursing staff. What is the best response by the nurse manager to an RN who states that an unlicensed assistive personnel (UAP) consistently leaves patient units untidy? a. "Plan to meet with me and the UAP; I will get back to you with the details by the end of the day.” b. “I will speak to the UAP but I need you to put the problem in writing.” c. “Please plan to bring up environmental clutter concerns at the next unit meeting.” d. “Discuss the issue with the UAP and see if the two of you can come up with a solution.” 1.25 points Question 41 1. During a unit meeting, nursing staff identifies a concern with the process of shift report. The nurse manager says “Fine, go ahead and do something else.” Which style of leadership is the nurse manager using? a. Laissez-faire b. Transformational c. Democratic d. Authoritarian 1.25 points Question 42 1. Which ethical principle is the nurse violating when the nurse tells a crying child, “If you don’t swallow this pill, I am going to give you a shot into your leg.”? a. Nonmaleficence b. Fidelity c. Obligation d. Justice 1.25 points Question 43 1. The RN is teaching a group of graduate nurses about clinical pathways. Which statement indicates additional teaching is needed? a. Clinical pathways allow monitoring of variances from prescribed plans of care. b. Clinical pathways encourage multidisciplinary documentation. c. Clinical pathways streamline the charting process. d. Clinical pathways eliminate the need for quality control activities. 1.25 points Question 44 1. Which nursing theory model helps direct nursing care for a patient at the end of life who is seeking inner harmony and spiritual meaning? a. Watson Model of Human Caring b. Roy Adaptation Model c. Orem Self Care Model d. King Model of Goal Attainment 1.25 points Question 45 1. An RN states, “I feel emotionally drained and physically sick after caring for some patients who receive aggressive treatments. It seems like we are only prolonging their dying process.” What is this RN experiencing? a. Work overload b. Disillusionment in nursing c. Moral distress d. Cultural shock 1.25 points Question 50 1. Which ethical principle is implicit in the statement “Provision of safe, competent care without patient harm is a healthcare provider’s duty.”? a. Nonmaleficence b. Veracity c. Autonomy d. Justice 1.25 points Question 51 1. Which patient would be most appropriate for the RN to assign to the LPN/LVN? a. A patient with a hip fracture who requires a blood transfusion. b. A newly admitted patient with pneumonia who needs a care plan developed. c. A patient who had a stroke and is awaiting transfer to a subacute facility. d. A patient with newly diagnosed diabetes mellitus who needs a home care referral. 1.25 points Question 52 1. A patient receiving home care is prescribed an analgesic medication that is twice the dose recommended by the manufacturer. Before administering the initial dose of the medication, what is the best response by the RN? a. Contact the prescribing provider for clarification of the dose. b. Inform the patient the dose might be lethal and can not be administered. c. Use nursing judgment and give half of the dose prescribed by the health care provider. d. Administer the dose as prescribed because it has been dispensed by a pharmacist. 1.25 points Question 53 1. Which nursing theory describes health as a person’s ability to adjust to health and illness along a continuum? a. Roy Adaptation Model b. Orem Self-Care Model c. Neuman Health-Care-Systems Model d. Johnson Behavioral System Model 1.25 points Question 54 1. Which elements must be included in a comprehensive risk management program? Select All that apply. a. Strategies to promote affordability of health care. b. Needs and preferences of patients. c. Multidisciplinary team membership. d. Focus on high-risk areas such as medication errors. e. Safety needs of patients, staff, and visitors. 1.25 points Question 55 1. A student nurse asks the RN to explain the term “just culture” in healthcare. Which concept is included in the RN’s response? a. Mutual respect among health care professionals. b. Blame-free, proactive approach to human error. c. Equal pay for equal work. d. Elimination of ethnic bias. 1.25 points Question 56 1. The homecare RN is coordinating care for a chronically ill patient. Which task can be delegated to the unlicensed assistive personnel (UAP)? a. Teach family to administer pain medication orally. b. Auscultate lung sounds and report abnormals to the RN. c. Evaluate gait and the potential need for a walker. d. Assist with bathing during every visit. 1.25 points Question 61 1. An unlicensed assistive personnel (UAP) says “I am not sure I calculated the intake and output correctly, but I know the nurse is always responsible.” Which is an appropriate response by the RN to the UAP? a. “When you agree to perform a task, you are responsible for your actions in carrying it out.” b. “You are working under the RN's license when you accept responsibility for this task.” c. “UAPs can not record intake and output, you should not have done those tasks.” d. “The RN does not need to supervise tasks that are within the UAP job description.” 1.25 points Question 62 1. A patient with end stage heart disease is seeking a heart transplant. What ethical principle supports the eligibility criteria that reviews the patient’s history of adherence to the medical treatment plan? a. Beneficence b. Distributive justice c. Veracity d. Autonomy 1.25 points Question 63 1. Which nurse would best assist a patient diagnosed with breast cancer requiring radiation and chemotherapy? a. Forensic nurse b. Nurse navigator c. Client safety nurse d. Nurse researcher 1.25 points Question 64 1. A child of a person with Alzheimer’s dementia asks the RN about obtaining a genetic test to identify personal risk for the disease. During which step in the ethical decision-making process does the RN explore personal bias about the issue? a. Planning b. Diagnosis c. Assessment d. Evaluation 1.25 points Question 65 1. The RN is returning to work after placing a family member in Hospice care. Which response should the RN use when a terminally ill client asks, “Should I sign a do not resuscitate order?” a. “If you would like to seek spiritual counseling, I can call pastoral care.” b. “This is a difficult situation; what are your views on end of life care?” c. “I would choose not to be resuscitated, too.” d. “I just put my mother in Hospice care with a do not resuscitate order.” 1.25 points Question 66 1. A patient requires transfer to a long term nursing care facility after an extended acute care 1. Which of the following is a contributing factor to the higher patient mortality rates in the United States as compared to other developed countries? a. Diversity of the population. b. Aging of the population. c. Limited access to healthcare. d. Population density. 1.25 points Question 71 1. A student nurse asks an RN “What strategies are useful when faced with an ethical dilemma in professional practice?” How does the RN respond? Select all that apply. a. “I consult the ethics committee when the problem is complex.” b. “I use the Nursing Code of Ethics for guidance.” c. “I defer to the healthcare provider to make the correct decision.” d. “I use the nursing process to organize my thought process.” e. “I focus on myself and what I would I do if faced with the issue.” 1.25 points Question 72 1. The RN is preparing to share information for the nursing journal club. Which selection criteria for the article will provide the best information for evidence-based practice? a. Journal article published six (6) years ago. b. Research based article addressing gap in knowledge. c. Data published by a healthcare provider on social media. d. Case study based on an unusual patient situation. 1.25 points Question 73 1. What does the RN anticipate as a societal health care need in the future? a. Growth in the aging population. b. Expansion of acute care capacity. c. Increase use of task orientated nurses. d. Paternalistic approach to the plan of care. 1.25 points Question 74 1. An RN is assessing a patient when the patient suddenly becomes confused and anxious. Which resource is most important for the RN to contact? a. Rapid response team. b. Resuscitation team. c. Risk management team. d. Security response team. 1.25 points Question 75 1. Which of the following is an example of a quantitative research design? a. An experimental study assessing medication effectiveness. b. Interviews to learn about ethnic heritage and traditions. c. Historical research on the role of nursing during the American Revolution. d. A case study describing a patient’s medical situation and care. 1.25 points Question 76 1. A patient refused to receive blood products based on religious beliefs. The patient had unexpected blood loss during surgery. Which action by the healthcare team is consistent with patient autonomy? a. Encourage the family to agree to a do not resuscitate order.